B7-H1在直肠癌与镶嵌血管中的表达及意义

目的 探讨共刺激配体B7-H1在直肠癌和镶嵌血管中的表达及临床意义.方法 应用免疫组织化学方法 观察50例直肠癌患者癌组织和镶嵌血管中的B7-H1表达,探讨B7-H1表达和直肠癌的病理学特征及预后间的关系.结果 随访期13例患者死亡,37例存活患者的中位随访期为3.4年(0～5年);64%的标本显示蛋B7-H1阳性染色,中位染色评分为2.5(0～4);B7-H1阳性表达与临床和病理特征呈逆相关(P＜0.05).15例(30%)的肿瘤患者同时B7-H1和镶嵌血管表达阴性,3例(6%)B7-H1阴性而镶嵌血管阳性,13(26%)B7-H1阳性而镶嵌血管阴性,19例(38%)B7-H1和镶嵌血管同时阳性表达.B7-H1阳性的肿瘤患者较N7-H1阴性的患者更可能镶嵌血管表达阳性(59.3%比11.1%;P＜0.01).双阳性组的生存率明显低于阴性或单阳性组(P＜0.01).21例表达镶嵌血管的直肠癌标本中有8例显示镶嵌血管内的内皮细胞或肿瘤细胞存在B7-H1的表达.结论 在直肠癌及镶嵌血管中阳性表达的B7-H1可作为直肠癌患者的预后标志.B7-H1参与直肠癌及镶嵌血管的免疫逃逸.

The clinical significance of B7-H1 expression in rectal cancer and mosaic vessel

Objective To investigate the clinical significance of costimulatory ligand B7-H1expression in rectal cancer and mosaic vessel.Methods The B7-H1 expression was detected by using immunohistochemistry in 50 cases of rectal cancer and the mosaic vessel from 2004 to 2008.The relationship between B7-H1 expression and the pathologic features and postoperative prognosis of patients with rectal cancer was analyzed subsequently.Results During the period of follow-up,there were 13 deaths in 50 patients.Among the rest 37 patients,the median duration of follow-up was 3.2 years(range 0-5 years).Thirty-two(64%)specimens exhibited positive tumor B7-H1 staining with a median level score of staining of 2.5(range of 0-4).Positive tumor B7-H1 expression was associated with adverse clinical and pathologic features,including larger tumor size,higher tulilor stage and grade,and lymphocytic infiltration(P＜0.05).There were 15(30%)tumors negative for both B7-H1 and mosaic vessel,3(6%)negative for B7-H1 and positive for mosaic vessel,13(26%)positive for B7-H1 and negative for mosaic vessel,and 19(38%)positive for both B7-H1 and mosaic vessel.Tumors positive for B7-H1 were more likely to be mosaic vessel positive than tumors negative for B7-H1(59.3%versus 11.1%;P＜0.01).The survival rate of patients positive for both with B7-H1 and mosaic vessel was significantly lower than in those negative for both or singly positive(P＜0.01).Eight specimens exhibited B7-H1 endothelial or carcinonlatous expression within the tuniormosaic vasculature(8/21,38.1%).Conclusion The positive expression of B7-H1 in rectal cancer and mosaic vessel may contribute to predict factor of prognosis of patients with rectal cancer.B7-H1 participate in the immune escape of cancer cells and mosaic vessed,and it may become a beneficial target for immunotherapy in human rectal cancer.