| Objective: Ovarian tumors is one of the common major tumors of female reproductive system, the epithelial tumors are the most common ovary tumors, account for 50%～70% of primary ovarian neoplasms and 85%～90% of all ovarian malignancies. Ovarian cancer is predominantly seen in middle and aged women, the symptoms are insidious in onset, the early diagnosis is difficult and the mortality is high. Recent years,the transvaginal ultrasound (TVUS), measurement of serum CA125 levels and radical surgical cytoreduction followed by platinum and taxane-based polychemotherapy in various combinations have become the early diagnostic and effective therapeutic methods for ovarian cancer. However, complete surgical excision of advanced ovarian cancer is very difficult and conventional chemotherapy generally associated with a large number of toxic side effects, the 5-year survival rate of advanced ovarian cancer is still very low. Clearly there is a need to discover the tumor genesis in order to develop novel therapies for the treatment of ovarian cancer, tumor development and progression is related with host immune system. T cell is at the central position in immune response of body versus tumor cells, which would be a most effective and most safe approach to eliminate tumor if it can arouse the immune system. The activation of T lymphocytes needs double signals: one is antigenic peptide-MHC complex, which is recognized by T cell receptor; one is co-stimulatory signal. Thus, co-stimulatory molecule is very important to the initiation of immune system.B7-H4 is an new member of the co-stimulatory family, recent study confirmed it can inhibit influence the activation and function of T response. At present, there are few experiments about the expression of B7-H4 in ovarian epithelial tumors. This study was designed to evaluate the expression of B7-H4 protein in ovarian epithelial tumors and its relation with ovarian cancer clinicopathological variables, and discussed its role in occurrence process of ovarian tumors, in order to find out a new method for diagnosis and therapy of ovarian cancer.Method: The expression of B7-H4 in 23 cases of serous cystadeno- carcinoma,8 cases of borderline serous cystadenoma,18 cases of serous cystadenoma,10 cases of mucinous cystadenocarcinoma,6 cases of border- line mucinous cystadenoma, 11 cases of mucinous cystadenoma, 6 cases of endometrioid carcinoma and 8 cases of clear cell carcinoma tissue were assessed by immunohistochemical staining. The data was analyzed by SPSS 17.0, and examined the correlation between B7-H4 expression and histological type, tumor grade, operation-pathological stage and age.Results: 1 Immunohistochemical staining: The positive expression of B7-H4 was buffy grains and mainly stains in tumor cell cytoplasm and circum- ferential membrane.2 B7-H4 positive expression was detected in primary serous (95.7%,22/23), endometrioid (100%,6/6), and clear cell carcinomas (87.5%, 7/8).By contrast,B7-H4 positive expression was detected in only 1/10 mucinous carcinomas, the positive rate was 10%,the differences were statistically significant﹙P<0.001﹚. The total positive rate of B7-H4 in ovarian was 76.6% (36/47).3 The proportion of positive expression was greater in ovarian carcinomas than in borderline cystadenoma(28.6%,4/14) and benign tumors(24.1%,7/29),the differences were statistically significant﹙P<0.001﹚.4 No correlation was observed between the proportion of B7-H4 positive expression in ovarian carcinomas with tumor grade, operation- pathological stage and age.Conclusion: The expression rate of B7-H4 was higher in ovarian cancer than in borderline cystadenoma and benign tumors, this suggests that B7-H4 should be further investigated as a new diagnostic marker for ovarian cancer, and the blockade of B7-H4 in ovarian cancer might be one strategy to pursue for future immunotherapy in ovarian cancer.
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