Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Ann Thorac Surg. 2011 Apr;91(4):1025-31. doi: 10.1016/j.athoracsur.2010.12.041.
The costimulatory molecule B7-H1 (programmed death-1 ligand-1, PD-L1) has been implicated as a potential regulator of antitumor immunity in various human cancers. To date, no data are available on the role of B7-H1 in Barrett carcinoma. Therefore, we investigated the expression pattern and clinical significance of B7-H1 in a large cohort of patients with Barrett carcinoma.
Expression of B7-H1 was evaluated by immunohistochemistry in 101 patients with Barrett carcinoma. Expression data were correlated with clinicopathologic features, including TNM stage, UICC (Union Internationale Contre le Cancer) tumor stage, tumor grade, resection status, and survival, and with the number of tumor-infiltrating CD3(+), CD8(+), and CD45RO(+) T lymphocytes.
Aberrant B7-H1 expression was found in Barrett carcinoma cells. High tumor B7-H1 expression was significantly associated with advanced T stage (p = 0.002), advanced UICC tumor stage (p = 0.022), and incomplete resection status (p = 0.009). The median survival of patients with high tumor B7-H1 expression was 38 months compared with 136 months for patients with no or low tumor B7-H1 expression. In the multivariable analysis, high tumor B7-H1 expression was significantly associated with an increased risk of death from Barrett carcinoma (hazard ratio, 3.50; 95% confidence interval, 1.66 to 7.38; p < 0.001).
Our data suggest that B7-H1 may represent a new prognostic marker for patients with Barrett carcinoma. Furthermore, given its immune-inhibitory function, B7-H1 may represent a potential target in the treatment of Barrett carcinoma.
共刺激分子 B7-H1（程序性死亡配体 1，PD-L1）已被认为是多种人类癌症中抗肿瘤免疫的潜在调节剂。迄今为止，尚无关于 B7-H1 在 Barrett 癌中的作用的数据。因此，我们研究了 B7-H1 在一大群 Barrett 癌患者中的表达模式及其临床意义。
采用免疫组织化学法检测 101 例 Barrett 癌患者的 B7-H1 表达情况。将表达数据与临床病理特征（包括 TNM 分期、UICC（国际抗癌联盟）肿瘤分期、肿瘤分级、切除状态和生存情况）以及肿瘤浸润 CD3(+)、CD8(+)和 CD45RO(+)T 淋巴细胞的数量进行相关性分析。
在 Barrett 癌细胞中发现了异常的 B7-H1 表达。高肿瘤 B7-H1 表达与较晚的 T 分期（p = 0.002）、较晚的 UICC 肿瘤分期（p = 0.022）和不完全切除状态（p = 0.009）显著相关。高肿瘤 B7-H1 表达患者的中位生存时间为 38 个月，而低或无肿瘤 B7-H1 表达患者的中位生存时间为 136 个月。在多变量分析中，高肿瘤 B7-H1 表达与 Barrett 癌死亡风险增加显著相关（风险比，3.50；95%置信区间，1.66 至 7.38；p < 0.001）。
我们的数据表明，B7-H1 可能是 Barrett 癌患者的一个新的预后标志物。此外，鉴于其免疫抑制功能，B7-H1 可能是 Barrett 癌治疗的一个潜在靶点。
