食管鳞状细胞癌组织中牙龈卟啉单胞菌感染和负性共刺激因子B7同源体4表达与患者生存的关系

Relationship between the Porphyromonas gingivalis infection and negative co-stimulatory factor B7 homologue 4 expression in cancer tissue and the survival of patients with esophageal squamous cell carcinoma

目的探讨食管鳞状细胞癌(ESCC)组织中牙龈卟啉单胞菌(Pg)感染和负性共刺激因子B7同源体4(B7H4)表达与患者生存的关系。方法选择2014年1月至2014年12月安阳市肿瘤医院收治的110例ESCC患者为研究对象,并收集手术切除的癌组织标本。采用免疫组织化学染色法检测ESCC组织中Pg感染及B7H4表达情况。采用Cohen′s kappa系数检验ESCC组织中Pg感染与B7H4表达的一致性。采用Kaplan-Meier法分析ESCC组织中Pg感染及B7H4阳性表达与患者生存的关系。采用单因素和多因素Cox回归分析ESCC组织中Pg感染、B7H4表达及患者临床病理特征对生存的影响。结果110例ESCC患者癌组织标本中,Pg感染阳性且B7H4表达阳性33例(Pg+B7H4阳性组),Pg感染和B7H4表达不满足同时阳性77例(Pg+B7H4阴性组)。在ESCC组织中,Pg感染主要分布于癌细胞的细胞质,B7H4主要表达于癌细胞的细胞膜。ESCC组织中Pg感染与B7H4阳性表达具有显著一致性(Kappa=0.710,P<0.05)。ESCC患者Pg感染且B7H4阳性表达与性别、吸烟、饮酒及肿瘤分化程度、浸润深度、淋巴结转移和TNM分期显著相关(P<0.05),与患者的年龄无显著相关性(P>0.05)。Pg+B7H4阳性组和Pg+B7H4阴性组ESCC患者的5 a生存率分别为12.12%、32.46%,中位生存期分别为(19.000±5.742)、(38.000±5.265)个月(95%置信区间:7.746~30.254、27.682~48.318);Pg+B7H4阳性组ESCC患者的5 a生存率及5 a中位生存期均显著低于Pg+B7H4阴性组(χ^(2)=4.926、9.283,P<0.05)。单因素Cox回归分析结果显示,性别、吸烟、饮酒及肿瘤分化程度、浸润深度、淋巴结转移、TNM分期和Pg感染且B7H4表达阳性与ESCC患者生存有关(P<0.05)。多因素Cox回归分析结果显示,肿瘤分化程度、Pg感染且B7H4表达阳性是影响ESCC患者生存的独立危险因素(P<0.05)。结论ESCC患者癌组织中Pg感染与B7H4表达阳性具有显著一致性,Pg感染且B7H4阳性表达可促进ESCC的恶性进展,且不利于ESCC患者生存。

Objective To investigate the relationship between the Porphyromonas gingivalis(Pg)infection and negative co-stimulatory factor B7 homologue 4(B7H4)expression in cancer tissue and the survival of patients with esophageal squamous cell carcinoma(ESCC).Methods A total of 110 ESCC patients admitted to Anyang Cancer Hospital from January 2014 to December 2014 were selected as the research subjects,and the cancer tissue specimens of patients with ESCC were collected.The Pg infection and B7H4 expression in cancer tissues of patients with ESCC were detected by immunohistochemical staining.The consistency between Pg infection and B7H4 expression in cancer tissues of patients with ESCC was verified by Cohen′s kappa coefficient analysis.The relationship between the Pg infection and B7H4 positive expression in cancer tissues and the survival of patients with ESCC was analyzed by the Kaplan-Meier method.The effect of Pg infection,B7H4 expression and clinicopathological characteristics of patients with ESCC on survival were analyzed by univariate and multivariate Cox regression.Results Among the 110 cancer tissue specimens from ESCC patients,33 cases were positive for Pg infection and positive for B7H4 expression(Pg+B7H4 positive group),and 77 cases were not positive for both Pg infection and B7H4 expression(Pg+B7H4 negative group).In ESCC tissues,the infection of Pg was mainly in the cytoplasm of cancer cells,and the expression of B7H4 was mainly in cancer cell membranes.The infection of Pg in ESCC cancer tissue was significantly consistent with the positive expression of B7H4(Kappa=0.710,P<0.05).The gender,smoking,drinking and the degree of differentiation,depth of invasion,lymph node metastasis and TNM stage of tumor were significantly correlated with the Pg positive infection and B7H4 positive expression of patients with ESCC(P<0.05),but not significantly correlated with the age of patients(P>0.05).The 5-year survival rates of ESCC patients in the Pg+B7H4 positive group and Pg+B7H4 negative group were 12.12%and 32.46%,and the median survival times were(19.000±5.742)and(38.000±5.265)months(95%confidence interval:7.746-30.254,27.682-48.318),respectively;the 5-year survival rate and 5-year median survival time of ESCC patients in the Pg+B7H4 positive group were significantly lower than those in the Pg+B7H4 negative group(χ^(2)=4.926,9.283;P<0.05).The univariate Cox regression analysis showed that the gender,smoking,drinking and the degree of differentiation,depth of invasion,lymph node metastasis,TNM stage of tumor and the Pg positive infection and B7H4 positive expression were associated with the survival of patients with ESCC(P<0.05).The multivariate Cox regression analysis showed that the degree of differentiation of tumor,Pg positive infection and B7H4 positive expression were the independent risk factors affecting the survival of patients with ESCC(P<0.05).Conclusion The Pg positive infection and B7H4 positive expression in cancer tissues of patients with ESCC are significantly consistent.The Pg positive infection and B7H4 positive expression can promote the malignant progression of ESCC,and which are not conducive to the survival of patients with ESCC.