【摘要】 目的：探索新型免疫检查点淋巴细胞激活基因3(lymphocyte-activation gene 3,LAG-3)、纤维蛋白原样蛋白1(fibrinogenlike protein 1,FGL1)、主要组织相容性复合体Ⅱ类分子（major histocompatibility complex classⅡ，MHC-Ⅱ）在胃窦癌（gastric antral cancer,GAC）中的表达情况与预后的相关性。方法：收集2012年1月至2014年12月于天津医科大学肿瘤医院诊断为GAC的67例患者病理标本，分别进行石蜡切片制作，采用免疫组织化学法检测LAG-3、FGL1、MHC-Ⅱ三个指标的表达情况，并用统计学方法分析组间差异。采用Kaplan-Meier法评估LAG-3、FGL1、MHC-Ⅱ的表达水平与GAC患者预后之间的关系并绘制生存曲线。结果：GAC患者中，肿瘤大小<4 cm的患者和无淋巴结转移的患者LAG-3免疫细胞阳性率更高（P<0.05）；女性患者MHC-Ⅱ免疫细胞阳性率更高（P<0.05）。免疫细胞中LAG-3、MHC-Ⅱ高表达的患者总生存期（overall survival,OS）较好（P<0.05）；肿瘤细胞中MHC-Ⅱ高表达的患者OS、无病生存期（disease-free survival,DFS）较差（P<0.05）；而FGL1在免疫细胞和肿瘤细胞中的表达与OS、DFS无显著相关性（P>0.05）。结论：GAC患者LAG-3、MHC-Ⅱ在不同区域的表达量存在差异，GAC患者LAG-3及其配体在免疫细胞的表达对预后产生积极影响，提示免疫细胞中LAG-3/MHC-Ⅱ可以作为GAC患者预后标志物，为临床个体化免疫治疗提供新的依据。更多还原

【Abstract】 Objective: To investigate the expression of the immune checkpoint lymphocyte-activation gene 3(LAG-3), fibrinogen-like protein1(FGL1), and major histocompatibility complex class II(MHC-II) in gastric antral cancer(GAC) and determine their correlation with disease prognosis. Methods: The expression of LAG-3, FGL1, and MHC-II was analyzed in 67 patients with GAC admitted to Tianjin Medical University Cancer Institute & Hospital from January 2012 to December 2014 using immunohistochemistry. Variations between the groups were analyzed using statistical methods. The Kaplan-Meier method was used to evaluate the relationship between the LAG-3, FGL1, and MHC-II expression levels and the prognosis of patients with GAC. Results: LAG-3 expression level in immune cells was higher in patients with GAC presenting with a tumor size of <4 cm and in those without lymph node metastasis(P<0.05). Further, MHC-II expression level in immune cells was higher in female than in male patients(P<0.05). Patients with high LAG-3 and MHC-II expression levels in immune cells had better overall survival(OS, P<0.05); whereas, patients with high MHC-II expression levels in tumor cells had worse OS and disease-free survival(DFS,P<0.05). However, FGL1 expression in immune cells and tumor cells was not significantly correlated with OS and DFS(P>0.05).Conclusions: The LAG-3 and MHC-II expression levels in various regions of patients with GAC differ, and the expression of LAG-3 and its ligands in the immune cells of patients have a positive impact on prognosis. This suggests that LAG-3 and MHC-II in immune cells can be used as prognostic markers of GAC, providing a novel basis for individualized clinical immunotherapy.更多还原