结直肠癌患者血清可溶性共刺激分子B7-H3的表达水平及应用分析  

Expression level and application analysis of soluble costimulatory molecule B7-H3 in the serum of patients with colorectal cancer

作　　者：蒋明明 熊仲波 徐旻一 戴悦[1] 李亚男 王蕾[1] Jiang Mingming;Xiong Zhongbo;Xu Minyi;Dai Yue;Li Yanan;Wang Lei(Department of Clinical Laboratory,Shanghai Eighth People′s Hospital,Shanghai 200235,China)

机构地区：[1]上海市第八人民医院检验科,上海200235

出　　处：《中华预防医学杂志》2025年第3期382-389,共8页Chinese Journal of Preventive Medicine

基　　金：上海市徐汇区医学重点学科(SHXHZDXK202322);江苏大学医教协同创新基金(JDYY2023121)。

摘　　要：本研究探讨结直肠癌(CRC)患者肿瘤组织中共刺激分子B7-H3表达水平和血清中可溶性共刺激分子B7-H3(sB7-H3)的水平,以评估血清sB7-H3水平在结直肠癌辅助诊断中的临床价值。采用横断面研究设计,选取2020年1月至2022年12月在上海市第八人民医院治疗的232例CRC患者和87例结直肠良性疾病患者,以及59例健康体检者,检测血清中sB7-H3、CEA、CA199、CA724和CA50的水平。采用受试者工作特征(ROC)曲线分析sB7-H3和上述肿瘤标志物对CRC的诊断价值。通过免疫组化检测B7-H3在CRC组织和结直肠良性疾病组织中的表达水平。统计分析sB7-H3水平与临床病理特征之间的关系。结果显示,与结直肠良性疾病或健康对照组相比,CRC组的sB7-H3、CEA、CA199、CA724和CA50的血清水平均显著升高,差异有统计学意义(P<0.05)。在CRC组,sB7-H3的血清水平与CA50、CEA、CA724均呈较弱的正相关(r值分别为0.220、0.217、0.182,P值分别为0.005、<0.001、0.024),与CA199无显著相关性(r值为0.162,P=0.051)。sB7-H3、CEA、CA199、CA724、CA50诊断CRC的曲线下面积(AUC)分别为0.862、0.774、0.646、0.677和0.644,cut-off值分别为20.67 ng/ml、10.74 U/ml、3.17 ng/ml、3.16 U/ml和22.55 U/ml。以20.67 ng/ml为cut-off值,sB7-H3在CRC的阳性率为62.9%,显著高于结直肠良性疾病阳性率(35.6%)和健康对照阳性率(10%)(χ^(2)=81.995,P<0.001;χ^(2)=103.56,P<0.001)。病理分期Ⅲ、Ⅳ期患者的sB7-H3和CEA阳性率显著高于Ⅰ、Ⅱ期患者(χ^(2)=82.876,P<0.001;χ^(2)=22.617,P<0.001)。病理分期Ⅰ、Ⅱ期患者sB7-H3阳性率为56.2%,显著高于CEA的阳性率(38%)(χ^(2)=50.378,P<0.001)。免疫组化分析显示,B7-H3阳性染色主要分布在细胞质内,其在CRC阳性表达率(75.8%)明显高于结直肠良性疾病(15.4%)(χ^(2)=16.133,P<0.001)。CRC患者血清sB7-H3水平与肿瘤组织中B7-H3的表达水平呈正相关(r=0.766,P<0.001)。sB7-H3的血清水平与CRC的远处转移及病理分期显著相关(W=To investigate the expression level of costimulatory molecule B7-H3 in the tumor tissues and the level of soluble costimulatory molecule B7-H3(sB7-H3)in the serum of patients with colorectal cancer(CRC),so as to evaluate the clinical value of sB7-H3 in auxiliary diagnosis of CRC.A cross-sectional study design was adopted.A total of 232 CRC patients,87 patients with benign colorectal diseases,and 59 healthy subjects who were treated in Shanghai Eighth People′s Hospital from January 2020 to December 2022 were selected.The levels of sB7-H3,CEA,CA199,CA724 and CA50 in the serum were detected.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of sB7-H3 and the above-mentioned tumor markers for colorectal cancer(CRC).The expression levels of B7-H3 in CRC tissues and benign colorectal disease tissues were detected by immunohistochemistry.The relationship between the levels of sB7-H3 and clinicopathological features was analyzed statistically.The results showed that compared with the benign disease group or the healthy control respectively,the serum levels of sB7-H3,CEA,CA199,CA724 and CA50 in the CRC group were significantly increased,and the differences were statistically significant(P<0.05).In the CRC group,the serum levels of sB7-H3 showed a weak positive correlation with CA50,CEA and CA724(the r values were 0.220,0.217 and 0.182 respectively;the P values were 0.005,<0.001 and 0.024 respectively),and there was no significant correlation with CA199(the r value was 0.162;the P value were 0.051).The areas under the curve(AUC)of sB7-H3,CEA,CA199,CA724 and CA50 for diagnosing CRC were 0.862,0.774,0.646,0.677 and 0.644 respectively,and the cut-off values were 20.67 ng/ml,10.74 U/ml,3.17 ng/ml,3.16 U/ml,and 22.55 U/ml,respectively.Taking 20.67 ng/ml as the cut-off value,the positive rate of sB7-H3 in CRC was 62.9%,which was significantly higher than that in patients with benign colorectal diseases(35.6%)and the healthy control group(10%)(χ^(2)=81.995,P<0.001;χ^(2)=103.56,P<0.001).Th

关 键 词：结直肠癌 肿瘤标志物 辅助诊断 可溶性共刺激分子B7-H3 

分 类 号：R735.3[医药卫生—肿瘤]