协同刺激分子B7-H4与CD11c共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

Effects of coexpression of B7-H4 and CD11c on prognosis of patients with gastric cancer treated by cytokine-induced killer cells

目的 观察协同刺激分子B7-H4及黏附分子CD11c在胃癌组织中的不同表达水平,并观察其对细胞因子诱导的杀伤细胞（CIK）治疗对胃癌患者预后的影响.方法 应用免疫组织化学法检测88例胃癌患者手术标本中B7-H4及CD11c的表达水平.采用x2检验比较CIK联合化疗组与单纯化疗组患者临床资料的均衡性.采用Kaplan-Meier法和Log-rank检验比较B7-H4、CD11c不同表达水平及CIK联合化疗、单纯化疗患者无瘤生存期及生存期的差异.采用多因素Cox模型分析B7-H4、CD11c不同表达水平联合CIK治疗与复发和死亡的关联强度.结果 CIK联合化疗组和单纯化疗组除在肿瘤转移差异有统计学意义外,其余临床资料及B7-H4、CD11c表达水平在两组间分布差异无统计学意义（P＞0.05）.CIK联合化疗＋CD11c高表达＋B7-H4低表达患者无瘤生存期及生存期明显高于单纯化疗＋ CD11c低表达＋B7-H4高表达患者（59个月比15个月、67个月比22个月,P＜0.01）.调整了性别、年龄、TNM分期、肿瘤分化程度、肿瘤大小等混杂因素后,与CIK联合化疗＋ CD11c高表达＋B7-H4低表达组比较,单纯化疗＋CD1 1c低表达＋B7-H4高表达组患者的复发率和死亡率明显升高,其风险比（HR）[95％可信区间（CI）]分别为5.06（1.64 -15.56）、6.51（2.09 -20.29）.结论 CD11c高表达、B7-H4低表达胃癌患者接受CIK联合化疗的治疗方案将可能延长无瘤生存时间及生存时间.

Objective To investigate the effects of the expression level of costimulatory molecules B7-H4 and adhesion molecules CD11c combined with cytokine-induced killer cells （CIK） therapy on the prognosis of patients with gastric cancer.Methods Tissue specimens from 88 cases of gastric cancer were evaluated for the expression levels of B7-H4 and CD11c by immunohistochemistry.The balance of clinical data between CIK therapy combined with chemotherapy group and chemotherapy group was evaluated by using chi-square test.Median disease-free survival time and median survival time in patients with different expression levels of B7-H4,CD11 c and methods of treatment were compared by using Kaplan-Meier and Log-rank test.The Cox model was used to evaluate the hazard risk （HR） of the link strength between the different expression levels of B7-H4 and CD11c combined with CIK therapy and recurrence,mortality.Results There was no significant difference in clinical data and expression levels of B7-H4 and CD11c between CIK combined with chemotherapy group and single chemotherapy group except metastasis.The median disease-free time and median survival time were significant difference between CIK combined with chemotherapy group ＋ CD1 1c high ＋ B7-H4 low and chemotherapy group ＋ CD11 c low ＋ B7-H4 high （P 〈0.01）.Adjusted for sex,age,TNM stage,tumor differentiation,and tumor size,the recurrence and mortality were higher in single chemotherapy group ＋ CD1 1c low ＋ B7-H4 high as compared with CIK combined with chemotherapy group ＋ CD11 c high ＋ B7-H4 low （59 months vs.15 months,67 months vs.22months） with the HR value [95% confidence interval （CI）] being 5.06 （1.64-15.56） and 6.51（2.09-20.29） respectively.Conclusion Patients with high expression of CD11 c and low expression of B7-H4 in combination with the CIK chemotherapy may prolong disease-free survival time and survival time.