可诱导 T 细胞共刺激分子在结肠癌组织中的表达情况及其与 远期生存的相关性研究

目的 探讨分析可诱导 T 细胞共刺激分子 (inducible T-cell co-stimulator, ICOS) 在结肠癌组织中 的表达情况及其与远期生存的相关性。 方法 选取 2018 年 5 月至 2019 年 5 月期间在大连大学附属新华医 院进行手术切除结肠组织的 206 例结肠癌患者作为研究对象, 取其结肠癌组织及癌旁组织标本, 使用荧光 定量 PCR 检测结肠癌组织及癌旁组织中可诱导 T 细胞共刺激分子表达水平, 分析其表达与临床病理特征的 关系及远期生存的相关性。 结果 结肠癌组织中 ICOS 表达水平 (8. 73 ± 2. 25) 显著低于癌旁组织的 (18. 54 ± 3. 26), 差异有统计学意义 (P< 0. 05); 结肠癌组织中 ICOS 表达水平与肿瘤直径、 远处转移、 临 床分期、 淋巴结转移有关 ( P < 0. 05), 与年龄、 性别、 肿瘤部位、 分化程度差异无统计学意义 ( P > 0. 05); ICOS 表达在 206 例结肠癌组织的中低表达 117 例, 高表达 89 例; ICOS 高表达和低表达与临床病理 因素进行 Logistic 二次回归分析结果显示, ICOS 表达与肿瘤大小、 临床分期、 淋巴结转移、 远处转移有关 (P< 0. 05), 与年龄、 性别、 肿瘤位置、 分化程度无关 (P > 0. 05); 随访截止至 2021 年 9 月 30 日, 206 例 结肠癌患者存活率 83. 01 % (171 / 206), 死亡率 16. 99 % (35 / 206), 中位生存时间为 (23. 5 ± 3. 3) 个 月。 ICOS 高表达的 89 例结肠癌患者的中位生存期为 (27. 4 ± 3. 2) 个月, 95 % CI 为 2. 234 ~ 6. 147; ICOS 低表达的 117 例结肠癌患者的中位生存期为 (16. 3 ± 4. 3) 个月, 95 % CI 为 1. 458 ~ 5. 237, ICOS 高表达结 肠癌患者中位生存期显著高于 ICOS 低表达者 (P< 0. 05)。 结论 ICOS 在结肠癌组织中呈较低表达, 其表 达水平与患者远期生存呈正相关关系, 其水平可作为结肠癌患者预后生存的重要评估指标。

Expression of Inducible T Cell Costimulatory Molecules in Colon Cancer Tissues and Their Correlation with Long-term Survival

Objective To explore the expression of inducible T cell costimulatory molecules in colon cancer tissues and their correlation with long-term survival of colon cancer patients. Methods A total of 206 colon cancer patients who underwent surgical resection of colon tissue in Xinhua Hospital Affiliated to Dalian University from May 2018 to May 2019 were selected. Their colon cancer tissues and paracancerous tissues were used for the detection of inducible T-cell co-stimulator (ICOS) expression by fluorescence quantitative PCR. The relationships between the expression level of ICOS and the clinicopathological characteristics or the long-term survival were analyzed. Results The expression level of ICOS was significantly lower in colon cancer tissues (8. 73 ± 2. 25) than that in adjacent tissues (18. 54 ± 3. 26) (P< 0. 05). The expression level of ICOS in colon cancer tissues was related to tumor diameter, distant metastasis, clinical stage, lymph node metastasis (P< 0. 05), and no relation was found between ICOS expression level and age, gender, tumor location, and degree of differentiation (P > 0. 05). The expression level of ICOS in 206 colon cancer tissues was low in 117 cases, and high in 89 cases. Logistic regression analysis showed that ICOS expression was related to tumor size, clinical stage, lymph node metastasis, and distant metastasis(P< 0. 05), but not related to age, gender, lymph node metastasis, tumor location, and degree of differentiation (P > 0. 05). The 206 colon cancer patients were followed up until September 30, 2021, the survival rate was 83. 01 % (171 / 206), the mortality rate was 16. 99 % (35 / 206), and the median survival time was (23. 5 ± 3. 3) months. The median survival time of the 89 colon cancer patients with high expression level of ICOS was (27. 4 ± 3. 2) months, with a 95 % CI of 2. 24-6. 147. The median survival time of the 117 colon cancer patients with low expression level of ICOS was (16. 3 ± 4. 3) months, and the 95 % CI was 1. 458-5. 237. The median survival time of colon cancer patients with high expression level of ICOS was significantly higher than that of patients with low expression level of ICOS (P<0. 05). Conclusion ICOS is lowly expressed in colon cancer tissues, and its expression level is positively correlated with the long-term survival of patients. The expression level of ICOS can be used as an important evaluation index for the prognosis and survival of colon cancer patients.