肾透明细胞癌组织中B7-H1的表达及其与预后的关系

目的探讨B7-H1在肾透明细胞癌组织中的表达及其与预后的关系。方法采用免疫组织化学方法检测132例肾透明细胞癌患者术后肿瘤标本中B7-H1的表达,单因素及多因素分析B7-H1的表达与预后的关系。结果 132例患者中,B7-H1阳性46例（34.85%）,其中无瘤生存26例,复发6例,死亡14例,至最后随访期限,疾病无进展生存期（PFS）为（32.29±12.56）个月,总生存期（OS）为（27.08±15.43）个月;阴性86例（65.15%）,其中无瘤生存79例,复发3例,死亡4例,PFS为（38.77±20.00）个月,OS为（37.02±20.00）个月,两者比较差异有统计学意义（P〈0.05）。单因素分析表明,B7-H1阳性表达与肿瘤大小、原发肿瘤分期、区域淋巴结转移、远处转移、临床分期、组织学分级呈显著正相关（均P〈0.05）,而与患者年龄、性别无相关性。多因素分析表明,在控制肿瘤大小、TNM分期、临床分期、组织学分级的影响后,B7-H1阳性表达具有更高的肿瘤特异性死亡率[危险因素（RR）3.918,95%可信区间（95%CI）1.305～11.765,P〈0.05]和复发率[RR4.486,95%CI1.404～14.333,P〈0.05]。结论 B7-H1阳性表达与肾透明细胞癌患者术后死亡率及复发率呈正相关,B7-H1是肾透明细胞癌的一个独立预后因素。

Relationships between the expression of B7-H1 and prognosis in renal clear cell carcinoma

Objective To evaluate the relationships between the expression of B7-H1 and prognosis in renal clear cell carcinoma.Methods The expression of B7-H1 in 132 tumor tissues with renal clear cell carcinoma was analyzed by immunohistochemistry.The relationships between the expression of B7-H1 and prognosis were analyzed by univariate and multiple-factor analysis.Results The study revealed that the expression of B7-H1 were found in 46 patients （34.85%）.In the 46 positive cases,health survival occurred in 26,recurrence occurred in 6,and death occurred in 14.Disease progression-free survival （PFS） was （32.29±12.56） months,overall survival （OS） was （27.08±15.43） months.In the 86 negative cases,health survival occurred in 79,recurrence occurred in 3 cases,and death occurred in 4.PFS was （38.77±20.00） months,OS was （37.02 ±20.00） months,there was significant difference in two groups（P0.05）.Univariate analysis showed that the expression of B7-H1 positively correlated with primary tumor size,primary tumor classification,regional lymph node,distant metastases,clinical stage and histological grade （P0.05）.No relationship was observed between the expression of B7-H1 and patients＇ age and gender.Multiple-factor analysis showed that the expression of B7-H1was an independent predictor of cancer-specific death rate ／[RR 3.918,95% CI 1.305～11.765,P0.05／] and relapse rate ／[RR 4.486,95% CI 1.404～14.333,P0.05／] after for the control of primary tumor size,primary tumor classification,regional lymph node,distant metastases,clinical stage and immunotherapy.Conclusions The expression of B7-H1 positively correlated with cancer-specific death rate and relapse rate in renal clear cell carcinoma,and B7-H1 is an independent prognostic factor in renal clear cell carcinoma.