目的：检测结直肠癌组织中负性共刺激分子B7H1和B7H4的表达、T细胞亚群的浸润情况，探讨其临床意义。方法：收集苏州大学附属第四医院2003年1月至2003年12月50例结直肠癌患者的癌组织标本以及5例患者的癌旁组织标本，免疫组织化学法检测结直肠癌组织中B7H1和B7H4的表达以及T细胞亚群的浸润，分析B7H1、B7H4的表达与结直肠癌患者临床病理特征及T细胞浸润的相关性，分析B7H1、B7H4的表达和CD3+T、CD8+T淋巴细胞浸润程度与患者预后的相关性。结果：结直肠癌组织高表达B7H1(44%)和B7H4(56%)，而癌旁组织不表达（P<0.01）。B7H1在结肠癌组织中的表达较直肠癌显著升高（P<0.05）；随着Duke’s分期的升高，B7H4的表达水平也呈上升趋势（P<0.05）。结直肠癌组织中B7H1的表达与CD3+T细胞浸润呈负相关（P<0.05），但与B7H4的表达无关。B7H1的表达水平与患者预后呈负相关（P<0.05），且B7H1和B7H4同时高表达的患者总体生存率显著降低（P<0.05）。结论：负性共刺激分子B7H1和B7H4在人结直肠癌组织中高表达，并与患者总体生存率相关，两者的共同检测对结直肠癌诊断和预后判断具有一定的临床价值。

Objective:To examine the expression of coinhibitory molecules B7H1, B7H4 and infiltration of T cell subsets in colorectal carcinoma tissues, and to explore their clinical significances. Methods: Fifty tumor tissue specimens and 5 paracancerous tissues of 50 colorectal carcinoma (CRC) patients (from Jan. 2003 to Dec. 2003) in Fourth Affiliated Hospital of Soochow University were collected in the study. Immunohistochemistry staining was used for the detection of B7H1, B7H4 expression and T cell subset infiltration in CRC tissues, correlation between B7H1, B7H4 expression and clinical parameters of CRC patients was further analyzed. Results: B7H1 and B7H4 expression was found strong in CRC tissues but negative in paracancerous tissues (P<0.05). B7H1 expression in colon cancer tissues was significantly higher than that in rectal cancer (P<0.05), B7H4 expression was positively correlated to the Duke’s stage (P<005). B7H1 but not B7H4 expression in CRC tissues was negatively correlated to the infiltration of CD3+T cell (P<0.05). B7H1 expression was reversely related to the patients’ prognosis (P<0.05), and patients with high levels of both B7H1 and B7H4 showed a lower overall survival rate than other patients (P<0.05). Conclusion: Coinhibitory molecules B7H1 and B7H4 were highly expressed in human CRC tissues, and correlated to patients’ overall survival, and the joint detection of these molecules may have clinical value for diagnosis and prognosis of colorectal carcinoma.

苏州大学医学部研究生科研创新基金