共刺激分子B7-H3 mRNA和B7-H3蛋白在胃癌组织中的表达及其临床意义

Expression and clinical significance of costimulatory molecule B7-H3 mRNA and B7-H3 protein in gastric carcinoma

目的研究B7家族的新成员B7-H3mRNA和B7-H3蛋白在胃癌组织中的表达及其临床意义。方法采用荧光实时定量逆转录-多聚酶链反应（RT—PCR）方法检测38例胃癌患者癌组织及其邻近正常组织B7-H3mRNA的表达；免疫组织化学Elivision法检测B7．H3蛋白在胃癌组织中的表达。结果B7-H3mRNA在胃癌组织及其邻近正常组织中均有表达，其在胃癌组织中的表达明显低于邻近正常组织。B7-H3mRNA的表达与胃癌患者性别、年龄、组织类型、肿瘤大小、淋巴结转移、病理分级和浸润深度无关（P〉0.05）。B7-H3蛋白在胃癌组织中表达的阳性率为39、5％，其与患者性别、年龄、组织类型、肿瘤大小、淋巴结转移和浸润深度也无关（P〉0.05）。B7-H3蛋白表达随肿瘤临床分期的递增而降低，各组间差异有统计学意义（P=0.022）；病理分级各组间差异也有统计学意义（P=0.039）。Kaplan—Meier生存分析显示，B7-H3阳性表达组无病生存期明显优于B7-H3阴性表达组（P=0.009），B7-H3阳性表达组总生存期亦明显优于B7-H3阴性表达组（P=0.010）。结论B7-H3表达与胃癌预后有关，可以作为反映患者免疫状态和预后的一个新的指标．为制定临床治疗方案提供依据。

Objective To study the expression of B7-H3 mRNA and B7-H3 protein in gastric carcinoma and their clinical significance. Methods The expression of B7-H3 mRNA and B7-H3 protein in gastric carcinoma and the nearby normal tissue of 38 patients was detected by real-time RTPCR and immunohistochemical assay respectively. Results B7-H3 mRNA was expressed both in gastric carcinoma and nearby normal tissue, but the expression level in gastric carcinoma was much lower than that in nearby normal tissue. There were no significant differences of B7-H3 mRNA expression among gender, age, histological type, tumor size, lymph node metastasis and invasive depth （all P 〉 0.05）. The positive rate of B7-H3 protein expressed in gastric carcinoma was 39.5%. There were no significant differences of B7-H3 protein expression among gender, age, histological type, tumor size, lymph node metastasis and invasive depth （all P 〉0.05）, but there were significant differences among groups of clinical stage（P=0.022） and pathological grade （P=0.039）. Kaplan-Meier analysis revealed that disease-free survival or overall survival of the patients with positive B7-H3 expression were significantly longer than those with negative B7-H3 expression （P=0.009 and P=0.010 respectively）. Conclusion Detection of B7-H3 expression in gastric carcinoma will be beneficial to the judgment of the prognosis of gastric carcinoma and the choice of individualized treatment.