共刺激分子B7-H4表达对细胞因子诱导的杀伤细胞治疗胃癌患者预后的影响

Influence of co-stimulatory molecules B7-H4 expression on the prognosis of patients with gastric cancer treated with cytokine-induced killer cells adoptive immunotherapy

目的 评价共刺激分子B7-H4表达对细胞因子诱导的杀伤细胞（CIK细胞）过继免疫治疗胃癌患者后预后的影响.方法 采用回顾性队列分析156例胃癌的临床资料,并按其治疗情况分为对照组（81例,单纯化疗）和试验组（75例,化疗联合CIK细胞治疗）.对胃癌患者组织进行B7-H4免疫组织化学染色,并比较B7-H4不同表达情况下,对照组与试验组治疗后无瘤生存率的差异.结果 对照组和试验组间各临床病理资料的差异无统计学意义（p〉0.05）.两组术后中位无瘤生存时间分别为18.0个月和45.0个月（χ~2=11.631,P=0.001）,术后中位总体生存时间分别为27.0个月和49.0个月（χ~2=10.907,P=0.001）,差异均有统计学意义.86例B7-H4低表达者中,采用单纯化疗和CIK联合治疗后中位无瘤生存时间分别为32.0个月和62.0个月.差异有统计学意义（χ~2=4.663,P=0.03）;70例B7-H4高表达者中,采用单纯化疗和CIK联合治疗后中位无瘤生存时间分别11.0个月和18.0个月,差异有统计学意义（χ~2=11.971,P=0.001）.结论 采用化学治疗联合CIK细胞回输治疗胃癌,无论B7-H4高表达还是低表达,均可显著延长胃癌患者的无瘤生存时间.

Objective To investigate the influence of co-stimulatory molecules B7-H4 expression on prognosis of gastric cancer patients treated by cytokine-induced killer cells （CIK cells） adoptive immunotherapy. Methods Clinical data of 156 cases of gastric cancer patients were retrospectively analyzed.Patients were divided into chemotherapy group（n=81）and chemotherapy combined with CIK cell therapy group（n=75）.B7-H4 expression was detected in the surgical specimens of gastric cancer patients by immunohistochemistry assay.Disease-free survival was compared between the chemotherapy group and the CIK group at different expression levels of B7-H4. Results The difference was not statistically significant in all clinical and pathological data between the chemotherapy group and the CIK treatment group（P〉0.05）.The postoperative median tumor-free survival in two groups was 18.0 and 45.0 months,respectively,and the difference was statistically significant（χ~2=11.631,P=0.001）.The postoperative median survival time was 27.0 and 49.0 months,respectively,and the difference was statistically significant（χ~2=10.907,P=0.001）.In 86 patients with low B7-H4 expression,the median tumor-free survival time was 32.0 and 62.0 months,respectively,and the difference was statistically significant（X2=4.663.P=0.03）.In 70 patients with hish B7-H4 expression,the median tumor-free survival time was 11.0 and 18.0 months,respectively,and the difference was statistically significant （χ~2=11.971,P=0.001）. Conclusion The median tumor-free survival time of patients with gastric cancer may be further improved by chemotherapy combined with CIK cell therapy,regardless of the level of B7-H4 expression.