摘要：

目的: 观察协同刺激分子B7同系物4（B7 homolog 4, B7-H4）在人口腔舌鳞状细胞癌（oral tongue squamous cell carcinoma，OTSCC）中的表达，并探讨其与预后的关系。方法: 选取2006年1月至2018年12月在苏州大学附属第三医院病理科存档的99例OTSCC患者的癌组织、30例OTSCC患者的癌旁组织石蜡包埋块，通过免疫组织化学染色检测B7-H4在OTSCC癌组织、OTSCC癌旁组织中的表达情况，采用卡方检验分析OTSCC癌组织中B7-H4的表达与患者临床病理特征的关系，运用生存分析法（Kaplan-Meier法）分析B7-H4表达与患者总生存期（overall survival, OS）的关系，拟合Cox模型评价各临床病理特征与患者预后的关系。结果: 免疫组织化学检测结果显示，OTSCC组织中B7-H4无表达或低表达共40例，占总样本的40.4%，高表达59例，占总样本的59.6%；99例OTSCC患者临床病理资料分析结果显示，B7-H4的表达与临床分期、N分期相关（P<0.001）；Kaplan-Meier生存分析显示，B7-H4表达较高患者的OS低于B7-H4表达较低的患者，差异具有统计学意义（HR=1.013，95%CI=1.004~1.022，P<0.05）；单因素Cox回归生存分析模型示，T分期、组织分化程度、肿瘤大小、B7-H4表达与OTSCC患者预后相关（P<0.05）；在多因素Cox回归生存分析模型中，B7-H4高表达（HR=1.015，95%CI=1.005 3~1.024，P<0.01）和组织分化程度（HR=1.665，95%CI=1.004 7~2.760，P<0.05）可作为OTSCC患者预后评判的独立危险因素。结论: B7-H4的表达与OTSCC患者预后显著相关，其有助于OTSCC患者预后评估。

关键词: 口腔舌鳞状细胞癌, B7-H4, 免疫组织化学, 预后

Abstract:

Objective: To investigate the expression distribution and its relationship to prognosis of co-stimulation molecule B7 homolog4 (B7-H4) in oral tongue squamous cell carcinoma (OTSCC). Methods: The study selected paraffin-embedded blocks of cancerous tissues from 99 cases of OTSCC patients and adjacent non-cancerous tissues from 30 OTSCC patients, all of which were archived by the Department of Pathology at the Third Affiliated Hospital of Soochow University between January 2006 and December 2018. Immunohistochemistry was used to examine the B7-H4 expression in cancerous tissue and the para-cancerous tissue. Chi-square test was used to obtain the correlation between the B7-H4 expression in OTSCC tissues and clinical pathological features. Survival analysis (Kaplan-Meier method) was used to analyze the association between B7-H4 expression and patient overall survival (OS). Cox model was used to analyze the correlation between clinical pathological features and patient prognosis. Results: The immunohistochemistry results showed that B7-H4 was not expressed or low intensity expression in 40 cases (40.4% of the total sample), and high intensity expression in 59 cases (59.6% of the total sample) of OTSCC tissues. The results of clinical pathology data analysis in 99 patients with OTSCC showed that the expression of B7-H4 was correlated with clinical stage (P<0.001), and the expression of B7-H4 was correlated with N stage (P<0.001); Kaplan Meier survival analysis showed that the OS of patients with higher B7-H4 expression was lower than that of patients with lower B7-H4 expression, and the difference was statistically significant (HR=1.013, 95%CI=1.004-1.022, P<0.05). Uni-factor Cox model analysis indicated that T stage, degree of tissue differentiation, tumor size, and B7-H4 expression were correlated with the prognosis of OTSCC; multi-factor Cox model analysis indicated that B7-H4 high expression (HR=1.015, 95%CI=1.005 3-1.024, P<0.01) and degree of tissue differentiation (HR=1.665, 95%CI=1.004 7-2.760, P<0.05) were independent prognostic factors of OTSCC patients. Conclusion: B7-H4 expresses highly in OTSCC and can be used as a major factor in the prognosis evaluation of OTSCC patients.

Key words: oral tongue squamous cell carcinoma, B7-H4, immunohistochemistry, prognosis

中图分类号: 

• R782