【作者】 陆叶；

【导师】 王振欣；

【作者基本信息】 苏州大学 ， 临床医学（专业学位）， 2018， 硕士

【摘要】 【目的】探讨共刺激分子B7-H3在非小细胞肺癌中的表达水平以及其与非小细胞肺癌患者的临床相关因素和疾病进展之间的关系。【材料与方法】收集资料完整的非小细胞肺癌患者术后新鲜肿瘤组织50例及肿瘤交界组织50例。利用蛋白抽提液,抽提组织样本中的总蛋白,经BCA试剂盒进行总蛋白定量,然后用ELISA方法定量B7-H3蛋白,分析共刺激分子B7-H3的表达与非小细胞肺癌患者临床相关病理特征及疾病进展之间的关系。生存分析采用Log-rank时序检验和Kaplan-Meier生存曲线。所有统计学结果采用SPSS 22.0软件进行统计分析。【结果】1.本研究对NSCLC患者术后肿瘤组织和肿瘤交界组织中的B7-H3蛋白进行定量检测,发现肿瘤组织中B7-H3的表达均显著高于肿瘤交界组织(p=0.039),差异具有统计学意义。2.分析B7-H3在肿瘤组织及肿瘤交界组织中的表达水平与对应的临床特征。在肿瘤组织中,发现B7-H3在男性患者组织中的水平明显高于女性患者(p=0.021),在非腺癌组织中的表达高于腺癌组织(p=0.046),并且在有淋巴结转移的患者中的表达水平高于无淋巴结转移的患者(p=0.012),差异均具有统计学意义。而其与年龄,肿瘤大小,远处转移及分期均无统计学意义。而在肿瘤交界组织中,B7-H3的表达与性别,年龄,肿瘤大小,病理类型及TNM分期均无统计学意义。3.分析肿瘤组织中B7-H3表达水平对疾病进展的影响,发现B7-H3low的中位DFS为24.4个月,B7-H3high的中位DFS为27.2个月。B7-H3的高表达组中位DFS与低表达组中位DFS差异无统计学意义(p=0.811)。【结论】1.共刺激分子B7-H3在NSCLC肿瘤组织中的表达显著高于肿瘤交界组织。2.共刺激分子B7-H3的高表达与NSCLC的临床特征相关。在肿瘤组织中,B7-H3表达水平与性别,病理类型,淋巴结转移有关,而与年龄,肿瘤大小,远处转移及分期均无统计学意义;而在肿瘤交界组织中,B7-H3的表达与性别,年龄,肿瘤大小,病理类型及TNM分期均无统计学意义。3.共刺激分子B7-H3高表达与NSCLC病情进展无显著相关性。更多还原

【Abstract】 【Objective】To explore the expression level of the co-stimulatory molecule B7-H3 in non-small cell lung cancer(NSCLC)and its relationship with the clinical factors and disease progression.【Materials and methods】Fresh samples of tumor and adjacent tissues were acquired from 50 patients with NSCLC after operation.We quantified the total protein with The BCA Protein Assay Kit.Then,the ELISA method was used to quantify the B7-H3 protein.The relationship between the expression of B7-H3 and the clinicopathological features of NSCLC patients were analyzed.Also,we analyzed the correlation between the expression of B7-H3 and the disease progression.Actuarial PFS were calculated by the Kaplan-Meier method and analyzed using the log rank test.P values were considered to indicate a statistically significant difference at P<0.05.All analyses were performed using SPSS version 22.0 software.【Results】1.We quantified the B7-H3 protein of both tumor and adjacent tissues in NSCLC patients.We found that the expression in tumor tissues were significantly higher than those in tumor adjacent tissues(p=0.039),the difference has statistical significance(P<0.05).2.The correlation between expression level of B7-H3 and clinical characteristics in tumor tissues and adjacent tissues were analyzed.In the tumor tissues,the expression level of B7-H3 in the male patients was significantly higher than that in the female patients(p=0.021).B7-H3 expression level in non-adenocarcinoma tissues was significantly higher than that in adenocarcinoma group(p=0.046).The B7-H3 expression level in the patients with lymph node metastasis was significantly higher(p=0.012).There was no significant difference in age,tumor size,distant metastasis and staging.The expression level of B7-H3 in adjacent tissues was not related to gender,age,tumor size,histology and TNM staging.3.Assessing the influence of B7-H3 expression level on tumor progression,we found that there is no statistical significance between the expression level of B7-H3 and progression of NSCLC(p=0.811).The median disease-free survival(DFS)with B7-H3 low group is 24.4 months and the median DFS of B7-H3 high group is 27.2 months.【Conclusion】1.The expression of co-stimulatory molecule B7-H3 in NSCLC tumor tissues was significantly higher than that in tumor adjacent tissues.2.The expression level of co-stimulatory molecule B7-H3 was related with clinical features of NSCLC patients.We found that it is related to sex,histology and lymph node metastasis.However,there was no statistically significant difference between the expression level of B7-H3 with age,tumor size,distant metastasis and staging.The expression level of B7-H3 in adjacent tissues was not related to gender,age,tumor size,histology and TNM staging.3.There was no statistical significance between the level of expression of B7-H3 and progression of NSCLC.更多还原