子宫内膜癌中B7H4与MMR、CD8+TILs的相关性分析及其临床意义OA

Objective To investigate the expression and clinical significance of B7H4 in endometrial carcinoma,and to analyze its correlation with MMR status,CD8+TILs density as well as its impact on prognosis.Methods Im-munohistochemistry was used to detect the expression of B7H4 in 30 cases of normal endometrial tissues and 132 cases of endometrial carcinoma tissues.Meanwhile,the expression levels of four MMR proteins(MLH1,MSH2,MSH6 and PMS2)were examined in endometrial carcinoma.The density of CD8+TILs was quantified in both the tumor center and invasive margin.The differential expression of B7H4 between normal endometrium and endometrial carcinoma was compared.The relationship between the expression of B7H4 and the clinicopathological features,MMR protein sta-tus,CD8+TILs density and prognosis were analyzed.Results The positive rate of B7H4 was 59.1%(78/132)in en-dometrial carcinoma,and its expression was positively related with advanced FIGO stage and lymph node metastasis(P<0.05).The positive rate of B7H4 was significantly higher in deficient mismatch repair(dMMR)endometrial carci-noma than in proficient mismatch repair(pMMR)cases(P<0.05).Moreover,B7H4 expression showed negative cor-relations with CD8+TILs density both at the tumor invasive margin(r=-0.270,P<0.05)and in the tumor center(r=-0.226,P<0.05).Kaplan-Meier survival analysis indicated that endometrial carcinoma patients with positive expres-sion of B7H4 had shorter disease-free survival,but this difference did not reach statistical significance(P>0.05).Neither univariate and multivariate Cox regression analyses identified B7H4 expression as an independent prognostic factor for endometrial carcinoma patients(P>0.05).Conclusion B7H4 is closely implicated in the malignant pro-gression of endometrial carcinoma,and its high expression can inhibit the activity of T cells and contribute to the im-mune escape of tumor cells,suggesting that B7H4 holds promise as a potential target for immunotherapy in endome-trial carcinoma.