title: Serum B7-H4 expression is a significant prognostic indicator for patients with gastric cancer.
abstract: BACKGROUND
  B7-H4 is a novel B7 ligand that plays an important role in the T cell-mediated immune response as a negative regulator. Previous studies have suggested the aberrant expression of membrane B7-H4 in tumor cells. The aim of this study is to determine the expression levels of preoperative soluble B7-H4 (sB7-H4) in circulation and to investigate the correlations between sB7-H4 levels and clinicopathological parameters as well as the survival rate of patients with gastric cancer.
  
  
  METHODS
  Blood specimens from 132 patients with gastric cancer and 63 healthy volunteers were analyzed by sandwich enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Median concentrations of sB7-H4 in patients with gastric cancer were significantly higher than those in healthy volunteers (16.85 versus 10.46 ng/mL; P = 0.008). Median levels of sB7-H4 were significantly correlated with tumor size, lymph node metastasis, the depth of tumor invasion and tumor-node-metastasis classification (P = 0.002, P = 0.001, P = 0.041 and P <0.001, respectively), but not with sex, age, tumor location or histological subtype (all P >0.05). Additionally, the overall survival rate was significantly lower in patients with high sB7-H4 levels when compared with low sB7-H4 levels (50.0% versus 77.3%, χ2 = 10.78, P = 0.001). Moreover, multivariate analysis demonstrated that the risk of death was significantly higher in patients with high sB7-H4 levels than in those with low sB7-H4 levels (P = 0.039).
  
  
  CONCLUSIONS
  sB7-H4 is a valuable blood marker for predicting the progression and prognosis of patients with gastric cancer.
authors.forename: Hongbing
authors.initials: H
authors.lastname: Shi
authors.forename: Mei
authors.initials: M
authors.lastname: Ji
authors.forename: Jun
authors.initials: J
authors.lastname: Wu
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhou
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Li
authors.forename: Zhengguang
authors.initials: Z
authors.lastname: Li
authors.forename: Xiao
authors.initials: X
authors.lastname: Zheng
authors.forename: Bing
authors.initials: B
authors.lastname: Xu
authors.forename: Weiqing
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Department of Oncology, The Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou 213003, Jiangsu Province, People's Republic of China. czsdyrmyyzlk@163.com.
authors.forename: Changping
authors.initials: C
authors.lastname: Wu
authors.forename: Jingting
authors.initials: J
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000378:metabolism*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate; D060907:V-Set Domain-Containing T-Cell Activation Inhibitor 1 / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D060907:V-Set Domain-Containing T-Cell Activation Inhibitor 1; C475826:VTCN1 protein, human