黏附分子整合素CD11c对细胞因子诱导的杀伤细胞治疗胃癌疗效的影响

Influences of adhesion molecules integrins CD11c on cytokine induced killer cells curative effect on gastric cancer

探讨胃癌组织中黏附分子CD11c的表达与患者预后的关系,并分析CD11c的表达对细胞因子诱导的杀伤细胞（CIK）治疗胃癌患者复发和死亡风险的影响。采用免疫组织化学染色法确定CD11c表达;应用COX多因素模型分析化疗联合CIK治疗组（下称联合组）与CD11c表达状态联合影响胃癌复发和死亡的风险。单因素统计学分析显示：联合组＋CD11c高表达、联合组＋CD11c低表达、化疗组＋CD11c高表达和化疗组＋CD11c低表达患者的中位无瘤生存时间及中位生存时间差异有统计学意义（均P〈0.01）。在调整了性别、年龄、胃癌部位、肿瘤大小、分期、转移和治疗方式等混杂因素后,与联合组＋CD11c高表达组相比,化疗组＋CD11c低表达组复发和死亡风险显著增加（HR=5.76,95%CI=2.42~13.70;HR=5.00,95%CI=2.22~11.12）,且联合组＋CD11c高表达、联合组＋CD11c低表达、化疗组＋CD11c高表达和化疗组＋CD11c低表达患者复发和死亡的HR呈上升趋势（趋势检验,均P〈0.01）。肿瘤组织中CD11c高表达的胃癌患者采用化疗联合CIK细胞治疗可显著延长患者的生存时间,CD11c高表达可作为CIK细胞治疗的纳入标准。

This study aims to investigate the relationship between the expression of adhesion molecules integrins CD11 cand the prognosis of gastric cancer,and to analyze the influences of CD11 c,which expresses in gastric cancer,on the relapse and death risk of cytokine induced killer cells（CIK）curing gastric carcinoma patients.Immunohistochemistry and multivariate COX model were performed to detect the expressed status of CD11 cand to analyze chemotherapy combined with CIK（combination group）and CD11 cexpression status to association with the relapse and death risk of gastric carcinoma patients.Univariate analysis revealed that the median disease-free survival time and the median survival time of gastric carcinoma patients of combination group＋CD11chigh,combination group＋CD11clow,chemotherapy group＋CD11chigh and chemotherapy group＋CD11c low were different statistically（P〈0.01）.After adjusting for some confounders such as sex,age,gastric carcinoma site,size,stage,metastasis and treatment method,compared with combination group＋CD11chigh,the relapse and death risk were increased significantly in chemotherapy group＋CD11clow（HR=5.76,95%CI=2.42~13.70;HR=5.00,95%CI=2.22~11.12,respectively）,meanwhile there existed rising risk trend from combination group＋CD11chigh to chemotherapy group＋CD11clow（trend test,P〈0.01）.Gastric cancer patients who express CD11 chigh in their tumor tissues when treated with chemotherapy combined with CIK could prolong their survival time.Therefore,high expression of CD11 can be used as an index for CIK treatment in patients with gastric cancer.