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Increasing evidences have demonstrated that B7-H4 is associated with tumor development and prognosis. However, the clinical significance of B7-H4 expression in human osteosarcoma (OS) remains unclear. The aim of present study was to examine the B7-H4 expression and to explore its contribution in OS. B7-H4 expression in OS tissues was examined by immunohistochemistry. Soluble B7-H4 (sB7-H4) levels in blood were examined by ELISA. The association of B7-H4 expression with clinicopathological factors or prognosis was statistically analyzed. Our findings demonstrated that B7-H4 expression in OS tissues was significantly higher than those in paired normal bone tissues ( P  < 0.001). sB7-H4 level in OS serum samples was significantly higher than that in healthy controls ( P  = 0.005). High B7-H4 expression in tissues and sB7-H4 level were both correlated with advanced tumor stage ( P  < 0.001,  P  = 0.017, resp.) and distant metastasis ( P  = 0.034,  P  = 0.021, resp.). Additionally, high B7-H4 expression or serum sB7-H4 levels were significantly related to poor overall survival ( P  = 0.028,  P  = 0.005, resp.). B7-H4 in tissues and serum samples were an independent factor for affecting the survival time of OS patients ( P  = 0.004,  P  = 0.041, resp.). Collectively, our data suggest that the evaluation of B7-H4 expression in tissues and blood is a useful tool for predicting the progression of osteosarcoma and prognosis.

B7-H4 Expression Is Associated with Tumor Progression and Prognosis in Patients with Osteosarcoma