井贺楠++李静雅++许芝山++杨如++路平

[摘要] 目的 研究食管癌中CD137/CD137L的表达情况，并分析两者在食管癌中表达的意义及其与预后的关系。 方法 以购自上海芯超生物科技有限公司的食管癌组织芯片为研究对象，采用免疫组织化学方法检测组织芯片中87例食管癌组织及其相应的癌旁组织中CD137/CD137L的表达情况；采用χ2检验或Fisher's精确检验的方法分析食管癌及癌旁组织中CD137/CD137L的表达与临床病理特征的关系；采用Kaplan-Meier法分析CD137/CD137L的表达与食管癌患者预后的关系。 结果 在87例食管癌组织和相应的癌旁组织中CD137的阳性表达率分别为36.8%和72.4%，两者比较差异有统计学意义（P < 0.05）。在87例食管癌组织和相应的癌旁组织中CD137L的阳性表达率分别为57.5%和96.6%，两者比较差异有统计学意义（P < 0.05）。食管癌中CD137表达阳性率与浸润深度相关（P < 0.05），而与年龄、性别、肿瘤部位、分化程度、临床分期均不相关（P > 0.05）。食管癌中CD137L表达与临床分期相关（P < 0.05），而与年龄、性别、肿瘤部位、分化程度、浸润深度均不相关（P > 0.05）。CD137表达与食管癌患者的预后不相关（P=0.6301），CD137L表达与食管癌患者的预后相关（P=0.0368）。 结论 CD137L的表达水平是影响食管癌患者预后的独立因素；CD137/CD137L可能在食管癌的抗肿瘤免疫中發挥重要作用。

[关键词] 食管癌；CD137；CD137L；预后

[中图分类号] R735.1 [文献标识码] A [文章编号] 1673-7210（2017）01（b）-0004-05

The expression of CD137/CD137L in esophageal cancer and its correlation with prognosis

JING He'nan1，2 LI Jingya1 XU Zhishan1 YANG Ru1 LU Ping2 ZHAO Baosheng3 ZHONG Genshen1，2

1.Research Center of Life Sciences & Technology， the First Affiliated Hospital of Xinxiang Medical University， He'nan Province， Weihui 453100， China； 2.Department of Oncology， the First Affiliated Hospital of Xinxiang Medical University， He'nan Province， Weihui 453100， China； 3.The Second Department of Thoracic Surgery， the First Affiliated Hospital of Xinxiang Medical University， He'nan Province， Weihui 453100， China

[Abstract] Objective To investigate the expression of CD137/CD137L in esophageal cancer， and analyze the significance and correlation with disease prognosis. Methods The esophageal tissue chip purchased from Xinchao Biological Technology co. LTD， Shanghai was taken as the research object. Immunohistochemical method was used to detect the expression of CD137/CD137L of 87 cases of esophageal cancer tissues and its corresponding adjacent tissues in the tissue chip. Chi-square test or Fisher's inspection method was used to analyze the relationship of the expression of CD137/CD137L and the clinical pathological features in esophageal cancer tissue and corresponding adjacent tissue. Kaplan-Meier method was used to analyze the relationship between the expression of CD137/CD137L and the prognosis of esophageal cancer. Results The positive expression rate of CD137 in 87 cases esophageal cancer tissues and corresponding adjacent tissue was 36.8% and 72.4% respectively， the difference was statistically significant （P < 0.05）. The positive expression rate of CD137L in 87 cases esophageal cancer tissues and corresponding adjacent tissue was 57.5% and 96.6% respectively， the difference was statistically significant （P < 0.05）. The positive expression rate of CD137 in esophageal carcinoma tissues was related to depth of invasion （P < 0.05）， but no relation with gender， age， tumor site， differentiated degree and clinical stage （P > 0.05）. The positive expression rate of CD137L in esophageal carcinoma tissues was related to clinical stage （P < 0.05）， but no relation with gender， age， tumor site， differentiated degree and depth of invasion （P > 0.05）. The expression rate of CD137 was not related with the prognosis of esophageal cancer （P=0.6301）. The expression rate of CD137L was related with the prognosis of esophageal cancer （P=0.0368）. Conclusion The expression level of CD137L is a prognostic factor of esophageal cancer； CD137/CD137L may play an important role in antitumor immunity of esophageal cancer.

[Key words] Esophageal cancer； CD137； CD137L； Prognosis

食管癌是我国常见的消化道恶性肿瘤，其发病率在所有肿瘤中居第4位[1]。尽管有多种治疗策略，但食管癌5年生存率仍低于40%[2]，新的治疗手段仍有待进一步研发和探索。近些年来研究发现免疫治疗有望成为新的肿瘤治疗方法。众所周知，T淋巴细胞在抗肿瘤免疫中发挥主要作用，而T淋巴细胞的激活需要抗原呈递信号与协同刺激信号的双重协同刺激。研究发现，通过应用特定协同刺激分子的激动性或者抑制性单克隆抗体信号来调节机体的抗肿瘤免疫反应可达到抗肿瘤的效果[3]。……