中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2010年
5期
656-660
,共5页
蒋敬庭%吴昌平%沈月平%郑璐%吴骏%季枚%郑晓%吴雨岗%朱一蓓%LU Bin-feng%张学光
蔣敬庭%吳昌平%瀋月平%鄭璐%吳駿%季枚%鄭曉%吳雨崗%硃一蓓%LU Bin-feng%張學光
장경정%오창평%침월평%정로%오준%계매%정효%오우강%주일배%LU Bin-feng%장학광
胃癌%B7-H4,协同刺激分子%免疫治疗%生存期
胃癌%B7-H4,協同刺激分子%免疫治療%生存期
위암%B7-H4,협동자격분자%면역치료%생존기
Stomach carcinoma%B7-H4%Costimulatory molecules%Immunotherapy%Survival time
目的 探讨协同刺激分子B7-H4的表达与胃癌的关系,并分析B7-H4在胃癌组织中的不同表达水平对细胞因子诱导的杀伤细胞(CIK)治疗胃癌患者的复发和死亡的风险.方法 对156例胃癌病例(1998年1月1日至2009年12月31日),采用免疫组织化学染色及IHS评估法确定B7-H4的表达状态,使用回顾性队列研究方法调查每位病例的人口学、临床资料及复发时间和死亡时间.应用COX多因素模型分析B7-H4高表达影响胃癌复发和死亡的风险.结果 胃癌组织B7-H4高表达组与B7-H4低表达组比较,患者中位无瘤生存时间(月)及95%CI分别为16(11.9～20.1)和47(22.4～71.6),中位生存时间(月)及95%CI分别为25(19.0～31.1)和43(35.2～50.8).在化学治疗组中,B7-H4低表达患者的中位生存时间明显高于B7-H4高表达患者(36比16),差异有统计学意义(x2=14.14,P<0.01).在化疗联合CIK治疗组中,B7-H4低表达患者的中位生存时间有高于B7-H4高表达患者的趋势(55比34),但差异无统计学意义(x2=1.78,P>0.05).在化学治疗组中,B7-H4低表达患者中位无瘤生存时间高于B7-H4高表达(33比11),差异有统计学意义(x2=18.956,P<0.01).在化疗联合CIK细胞治疗组中,B7-H4低表达患者中位无瘤生存时间显著高于高表达组(90比18),差异有统计学意义(x2=3.842,P<0.05).在调整了性别、年龄等混杂因素后,与B7-H4低表达比较,B7-H4高表达组病例的复发和死亡风险明显增加(RR=2.30,95%CI=1.41～3.75;RR=1.90,95%CI=1.20～3.01).结论 B7-H4高表达可能是提高胃癌复发和死亡风险的独立危险因素.采用CIK细胞回输治疗可控制和干预B7-H4的表达并延长胃癌患者的中位生存时间,胃癌B7-H4低表达可作为CIK细胞治疗的纳入标准.
目的 探討協同刺激分子B7-H4的錶達與胃癌的關繫,併分析B7-H4在胃癌組織中的不同錶達水平對細胞因子誘導的殺傷細胞(CIK)治療胃癌患者的複髮和死亡的風險.方法 對156例胃癌病例(1998年1月1日至2009年12月31日),採用免疫組織化學染色及IHS評估法確定B7-H4的錶達狀態,使用迴顧性隊列研究方法調查每位病例的人口學、臨床資料及複髮時間和死亡時間.應用COX多因素模型分析B7-H4高錶達影響胃癌複髮和死亡的風險.結果 胃癌組織B7-H4高錶達組與B7-H4低錶達組比較,患者中位無瘤生存時間(月)及95%CI分彆為16(11.9～20.1)和47(22.4～71.6),中位生存時間(月)及95%CI分彆為25(19.0～31.1)和43(35.2～50.8).在化學治療組中,B7-H4低錶達患者的中位生存時間明顯高于B7-H4高錶達患者(36比16),差異有統計學意義(x2=14.14,P<0.01).在化療聯閤CIK治療組中,B7-H4低錶達患者的中位生存時間有高于B7-H4高錶達患者的趨勢(55比34),但差異無統計學意義(x2=1.78,P>0.05).在化學治療組中,B7-H4低錶達患者中位無瘤生存時間高于B7-H4高錶達(33比11),差異有統計學意義(x2=18.956,P<0.01).在化療聯閤CIK細胞治療組中,B7-H4低錶達患者中位無瘤生存時間顯著高于高錶達組(90比18),差異有統計學意義(x2=3.842,P<0.05).在調整瞭性彆、年齡等混雜因素後,與B7-H4低錶達比較,B7-H4高錶達組病例的複髮和死亡風險明顯增加(RR=2.30,95%CI=1.41～3.75;RR=1.90,95%CI=1.20～3.01).結論 B7-H4高錶達可能是提高胃癌複髮和死亡風險的獨立危險因素.採用CIK細胞迴輸治療可控製和榦預B7-H4的錶達併延長胃癌患者的中位生存時間,胃癌B7-H4低錶達可作為CIK細胞治療的納入標準.
목적 탐토협동자격분자B7-H4적표체여위암적관계,병분석B7-H4재위암조직중적불동표체수평대세포인자유도적살상세포(CIK)치료위암환자적복발화사망적풍험.방법 대156례위암병례(1998년1월1일지2009년12월31일),채용면역조직화학염색급IHS평고법학정B7-H4적표체상태,사용회고성대렬연구방법조사매위병례적인구학、림상자료급복발시간화사망시간.응용COX다인소모형분석B7-H4고표체영향위암복발화사망적풍험.결과 위암조직B7-H4고표체조여B7-H4저표체조비교,환자중위무류생존시간(월)급95%CI분별위16(11.9～20.1)화47(22.4～71.6),중위생존시간(월)급95%CI분별위25(19.0～31.1)화43(35.2～50.8).재화학치료조중,B7-H4저표체환자적중위생존시간명현고우B7-H4고표체환자(36비16),차이유통계학의의(x2=14.14,P<0.01).재화료연합CIK치료조중,B7-H4저표체환자적중위생존시간유고우B7-H4고표체환자적추세(55비34),단차이무통계학의의(x2=1.78,P>0.05).재화학치료조중,B7-H4저표체환자중위무류생존시간고우B7-H4고표체(33비11),차이유통계학의의(x2=18.956,P<0.01).재화료연합CIK세포치료조중,B7-H4저표체환자중위무류생존시간현저고우고표체조(90비18),차이유통계학의의(x2=3.842,P<0.05).재조정료성별、년령등혼잡인소후,여B7-H4저표체비교,B7-H4고표체조병례적복발화사망풍험명현증가(RR=2.30,95%CI=1.41～3.75;RR=1.90,95%CI=1.20～3.01).결론 B7-H4고표체가능시제고위암복발화사망풍험적독립위험인소.채용CIK세포회수치료가공제화간예B7-H4적표체병연장위암환자적중위생존시간,위암B7-H4저표체가작위CIK세포치료적납입표준.
Objective To study the relation of B7-H4 expression and gastric cancer, and to analyze the impact of different expression levels of costimulatory molecules B7-H4 in gastric cancer tissues on survival time of gastric cancer patients treated with cytokine-induced killer cell biotherapy. Methods 156 gastric cancer patients who received operative treatment and were diagnosed pathologically in the Third Affiliated Hospital, Soochow University, were followed up from Jan. 1, 1998 to Dec. 31,2009. The B7-H4 expression was detected by using immunohistochemical staining and IHS assessment analysis. Demngraphic data, clinical data, recurrence and death time of gastric cancer patients were collected by the method of retrospective cohort study. Impact of B7-H4 high expression on the risk of gastric cancer recurrence and death was analyzed through multi-factor COX model. Results In B7-H4 high expression group and B7-H4 low expression group, the median tumor-free survival time (months) of gastric cancer patients and 95% CI of gastric cancer patients was respectively 16 ( 11.9-20. 1 ) and 47 ( 22.4-71.6 ), and 25 ( 19.0-31.1 )and 43 (35. 2-50. 8). In the chemotherapy group, the median survival time of gastric cancer patients in B7-H4 low expression group was significantly longer than that in B7-H4 high expression group ( 36 vs 16 ,x2 = 14. 14,P <0. 01 ). In the chemotherapy plus CIK treatment group, there was a tendency that the median survival time of gastric cancer patients in B7-H4 low expression group was longer than that in B7-H4 high expression group (55 vs 34), but there was no statistically significant difference (x2 = 1.78 ,P >0. 05). In the chemotherapy group, the median tumor-free survival time of gastric cancer patients in B7-H4 low expression group was significantly longer than that in B7-H4 high expression group (33 vs 11, x2= 18. 956,P <0. 01 ). In the chemotherapy plus CIK treatment group, the median tumor-free survival time of gastric cancer patients in B7-H4 low expression group was significantly longer than that in B7-H4 high expression group (90 vs 18 ,x2= 3. 842, P < 0. 05 ). After confounding factors such as sex, age and so on were adjusted, risk of recurrence and death of gastric cancer patients in B7-H4 high expression group was significantly higher than in B7-H4 low expression group ( RR =2. 30, 95% CI = 1.41-3. 75; RR = 1.90, 95% CI =1.20-3.01, respectively). Conclusion B7-H4 high expression may be an independent risk factor of increasing the risk of gastric cancer recurrence and death. CIK cell transfusion treatment can control and interfere in the B7-H4 expression, and prolong the median survival time of gastric cancer patients. B7-H4 low expression of gastric cancer can be considered as inclusion criteria of CIK cell biotherapy.
