【摘要】 目的探讨基线诱导型共刺激因子(ICOS)表达水平与食管癌病人术后预后的相关性。方法 2016年6月～2018年4月收治的食管癌病人139例。收集病人临床资料及术后病理标本,检测ICOS表达水平,以ICOS表达水平中位数为界值,分为ICOS低表达组(60例)和ICOS高表达组(60例)。所有受试者均接受食管癌切除术,随访2年后,比较两组病人预后不良风险。根据所有受试者预后情况分为预后不良组和预后良好组。分析病人预后不良风险及影响病人短期预后的影响因素,绘制工作特征曲线(ROC)分析基线ICOS表达水平的预测效能。结果截止末次随访时间2020年4月27日,139例病人共120例完成随访,最终纳入120例,其中共55例病人出现预后不良为预后不良组,未出现预后不良的65例病人作为预后良好组。K-M生存分析曲线显示,ICOS高表达组病人2年预后不良风险低于ICOS低表达组(P <0.05);多因素Logistics多因素分析显示,淋巴结转移(OR=0.132)、分化程度(OR=0.359)、基线ICOS低表达(OR=0.303)是食管癌病人术后预后不良的危险因素; ROC曲线分析显示,基线ICOS低表达预测病人术后预后不良风险的AUC为0.726。结论淋巴结转移、分化程度、基线ICOS低表达是食管癌切除术术后病人预后不良的危险因数,其中ICOS低表达可作为预测食管癌病人术后预后不良风险的重要指标。更多还原

【Abstract】 Objective To explore the correlation between the baseline expression of inducible costimulatory factor( ICOS) and the prognosis of patients with esophageal cancer after surgery. Methods A total of 139 patients with esophageal cancer diagnosed and treated from June 2016 to April 2018 in Zouping People’s Hospital were included as the research subjects. After admission,the clinical data and ICOS expression levels of the patients were collected,and the median ICOS expression level was used as the cutoff value. Divided into ICOS low expression group( n = 60) and ICOS high expression group( n =60). All subjects underwent esophageal cancer resection. After 2 years of follow-up,the two groups of patients after esophageal cancer resection were compared with the two-year risk of poor prognosis.According to the prognosis of all subjects,they were divided into a poor prognosis group and a good prognosis group. To analyze the risk of poor prognosis of patients after esophageal cancer resection and the influencing factors that affect the short-term prognosis of patients with esophageal cancer resection,draw a working characteristic curve( ROC) to analyze the predictive power of baseline ICOS expression level.Results As of the last follow-up time on April 27,2020,139 patients,120 patients in total,completed the follow-up,and 120 patients were finally enrolled. Among them,a total of 55 patients with a poor prognosis were classified as the poor prognosis group,and 65 patients without a poor prognosis were regarded as the prognosis Good group. KM survival analysis curve showed that the two-year risk of poor prognosis in patients with high ICOS expression group after esophageal cancer resection was lower than that in ICOS low expression group( P < 0. 05); multivariate Logistics multivariate showed lymph node metastasis( OR =0. 132) and degree of differentiation( OR = 0. 359) Baseline ICOS low expression( OR = 0. 303) is a risk factor for poor prognosis of patients after esophageal cancer resection; ROC curve analysis shows that baseline ICOS low expression predicts the AUC of poor prognosis risk for patients after esophageal cancer resection Is 0. 726. Conclusion Lymph node metastasis,degree of differentiation,and low baseline ICOS expression are risk factors for poor prognosis of patients after esophageal cancer resection. Low ICOS expression can be used as an important indicator for predicting the risk of poor prognosis for patients after esophageal cancer resection.更多还原