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[可溶性共刺激分子B7-H3在结直肠癌患者血清中的表达水平及应用分析]

[Expression level and application analysis of soluble costimulatory molecule B7-H3 in the serum of patients with colorectal cancer].

作者信息

Jiang M M, Xiong Z B, Xu M Y, Dai Y, Li Y N, Wang L

机构信息

Department of Clinical Laboratory, Shanghai Eighth People's Hospital, Shanghai 200235, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2025 Mar 6;59(3):382-389. doi: 10.3760/cma.j.cn112150-20241030-00861.

Abstract

To investigate the expression level of costimulatory molecule B7-H3 in the tumor tissues and the level of soluble costimulatory molecule B7-H3 (sB7-H3) in the serum of patients with colorectal cancer (CRC), so as to evaluate the clinical value of sB7-H3 in auxiliary diagnosis of CRC. A cross-sectional study design was adopted. A total of 232 CRC patients, 87 patients with benign colorectal diseases, and 59 healthy subjects who were treated in Shanghai Eighth People's Hospital from January 2020 to December 2022 were selected. The levels of sB7-H3, CEA, CA199, CA724 and CA50 in the serum were detected. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of sB7-H3 and the above-mentioned tumor markers for colorectal cancer (CRC). The expression levels of B7-H3 in CRC tissues and benign colorectal disease tissues were detected by immunohistochemistry. The relationship between the levels of sB7-H3 and clinicopathological features was analyzed statistically. The results showed that compared with the benign disease group or the healthy control respectively, the serum levels of sB7-H3, CEA, CA199, CA724 and CA50 in the CRC group were significantly increased, and the differences were statistically significant (0.05). In the CRC group, the serum levels of sB7-H3 showed a weak positive correlation with CA50, CEA and CA724 (the values were 0.220, 0.217 and 0.182 respectively; the values were 0.005,<0.001 and 0.024 respectively), and there was no significant correlation with CA199 (the value was 0.162; the value were 0.051). The areas under the curve (AUC) of sB7-H3, CEA, CA199, CA724 and CA50 for diagnosing CRC were 0.862, 0.774, 0.646, 0.677 and 0.644 respectively, and the cut-off values were 20.67 ng/ml, 10.74 U/ml, 3.17 ng/ml, 3.16 U/ml, and 22.55 U/ml, respectively. Taking 20.67 ng/ml as the cut-off value, the positive rate of sB7-H3 in CRC was 62.9%, which was significantly higher than that in patients with benign colorectal diseases (35.6%) and the healthy control group (10%) (=81.995, 0.001; 103.56, <0.001). The positive rates of sB7-H3 and CEA in patients with pathological stages Ⅲ and Ⅳ were significantly higher than those in patients with stages Ⅰ and Ⅱ (=82.876, 0.001; =22.617, <0.001). The positive rate of sB7-H3 in patients with pathological stages Ⅰ and Ⅱ was 56.2%, which was significantly higher than that of CEA (38%) (=50.378, <0.001). Immunohistochemistry showed that B7-H3 positive staining was mainly distributed in the cytoplasm. The positive expression rate of B7-H3 in CRC (75.8%) was significantly higher than that in benign colorectal diseases (15.4%) (16.133, 0.001). The serum level of sB7-H3 in CRC patients was positively correlated with the expression level of B7-H3 in tumor tissues (=0.766, <0.001). The serum level of sB7-H3 was significantly correlated with distant metastasis and pathological stage of CRC (=899, =0.002; =10.465, =0.015). In conclusion, serum level of sB7-H3 may have certain clinical value in the auxiliary diagnosis of CRC.

摘要

探讨共刺激分子B7 - H3在结直肠癌(CRC)患者肿瘤组织中的表达水平以及血清中可溶性共刺激分子B7 - H3(sB7 - H3)的水平,以评估sB7 - H3在CRC辅助诊断中的临床价值。采用横断面研究设计。选取2020年1月至2022年12月在上海第八人民医院就诊的232例CRC患者、87例大肠良性疾病患者和59例健康受试者。检测血清中sB7 - H3、癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原724(CA724)和糖类抗原50(CA50)的水平。采用受试者工作特征(ROC)曲线分析sB7 - H3及上述肿瘤标志物对结直肠癌(CRC)的诊断价值。通过免疫组织化学检测CRC组织和大肠良性疾病组织中B7 - H3的表达水平。对sB7 - H3水平与临床病理特征的关系进行统计学分析。结果显示,与良性疾病组或健康对照组相比,CRC组血清中sB7 - H3、CEA、CA199、CA724和CA50水平均显著升高,差异有统计学意义(P<0.05)。在CRC组中,血清sB7 - H3水平与CA50、CEA和CA724呈弱正相关(r值分别为0.220、0.217和0.182;P值分别为0.005、<0.001和0.024),与CA199无显著相关性(r值为0.162;P值为0.051)。sB7 - H3、CEA、CA199、CA724和CA50诊断CRC的曲线下面积(AUC)分别为0.862、0.774、0.646、0.677和0.644,截断值分别为20.67 ng/ml、10.74 U/ml、3.17 ng/ml、3.16 U/ml和22.55 U/ml。以20.67 ng/ml为截断值,CRC中sB7 - H3的阳性率为62.9%,显著高于大肠良性疾病患者(35.6%)和健康对照组(10%)(χ² = 81.995,P<0.001;χ² = 103.56,P<0.001)。病理分期Ⅲ和Ⅳ期患者中sB7 - H3和CEA的阳性率显著高于Ⅰ和Ⅱ期患者(χ² = 82.876,P<0.001;χ² = 22.617,P<0.001)。病理分期Ⅰ和Ⅱ期患者中sB7 - H3的阳性率为56.2%,显著高于CEA(38%)(χ² = 50.378,P<0.001)。免疫组织化学显示,B7 - H3阳性染色主要分布于细胞质。CRC中B7 - H3的阳性表达率(75.8%)显著高于大肠良性疾病(15.4%)(χ² = 16.133,P<0.001)。CRC患者血清sB7 - H3水平与肿瘤组织中B7 - H3的表达水平呈正相关(r = 0.766,P<0.001)。血清sB7 - H3水平与CRC的远处转移和病理分期显著相关(χ² = 8.99,P = 0.002;χ² = 10.465,P = 0.015)。综上所述,血清sB7 - H3水平在CRC辅助诊断中可能具有一定的临床价值。

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