血管内皮生长因子、缺氧诱导因子-1α在胃癌中的表达及其对预后影响的研究  

Expressions of VEGF,HIF-1α in Gastric Cancer and Their Impact on Prognosis

作　　者：沈承澜[1] 沈振斌[2] 陈伟东[2] 

机构地区：[1]上海中医药大学附属市中医医院外科,上海市200071 [2]复旦大学附属中山医院普外科

出　　处：《中国全科医学》2010年第22期2460-2463,2466,共5页Chinese General Practice

摘　　要：目的研究血管内皮生长因子(VEGF)、缺氧诱导因子-1α(HIF-1α)在胃癌组织中的表达和临床病理特征的关系,探讨它们在胃癌增殖、浸润、转移中的作用及对胃癌患者预后的影响。方法收集135例来自复旦大学附属中山医院1999年12月—2005年12月手术的胃癌病例,采用组织芯片和免疫组化法检测胃癌标本VEGF、HIF-1α表达情况,分析其与临床病理特征的关系及两者之间的相关性。用K-M生存分析及Cox回归单因素、多因素比较分析影响胃癌患者预后因素。结果胃癌组织VEGF、HIF-1α阳性表达均明显高于癌旁组织,差异有显著性(P<0.01),胃癌组织VEGF阳性表达与肿瘤直径、分化程度、浸润深度、淋巴结转移相关(P<0.05)。胃癌组织HIF-1α阳性表达与肿瘤浸润深度显著相关(P<0.01)。胃癌组织中VEGF、HIF-1α的表达呈正相关(P<0.01),单因素分析结果显示胃癌的肿瘤部位、Borrmann分型、浸润深度、淋巴结转移、TNM分期、VEGF阳性表达、HIF-1α阳性表达等影响因素与预后相关(P<0.05),多因素分析TNM分期、淋巴结转移、HIF-1α阳性表达为影响胃癌患者生存的独立预后因素(P<0.05)。结论 HIF-1α在胃癌中是肿瘤耐受缺氧的中心环节,VEGF和HIF-1α的阳性表达可作为判断肿瘤具有高度侵袭转移潜能和预后不良的重要指标。Objective To study the relationship between the expression of vascular endothelial growth factor （VEGF）,hypoxia-inducible factor -1α （HIF-1α） in gastric cancer tissue and the clinical pathologic feature,and explore their actions in progression,invasion,and metastasis,as well as the influence on prognosis.Methods The expressions of VEGF,HIF-1α were assessed by immunohistochemistry in tissue microarrays from 135 patients who were treated by radical gastrectomy in Zhongshan Hospital from Dec.1999 to Dec 2005.Correlations between the expressions of VEGF,HIF-1α and the clinical pathologic feature,as well as the relationship between the two were analyzed.Their impacts on the prognosis were evaluated by Cox regression and Kaplan-Meier analysis.Results The positive expression rates of VEGF and HIF- 1α in gastric cancer tissues were significantly higher than those in tumor-adjacent tissues （P0.01）.The expression of VEGF was associated with diameter of tumor,degree of differentiation,depth of invasion,lymph node metastasis （P0.05）.The expression of HIF- 1α was significantly associated with depth of invasion （P0.01）.Spearman rank correlation test showed there was a significantly positive correlation between expressions of VEGF and HIF- 1α （P0.01）.The univariate analysis revealed that tumor location,Borrmann type,depth of invasion,lymph node metastasis,TNM stage,the expressions of VEGF and HIF-1α were influential factors for the prognosis of patients （P0.05）.The multivariable Cox regressions proportional analysis showed that the TNM stage,lymph node metastasis,expression of HIF-1α were independent prognostic factors of gastric cancer （P0.05）.Conclusion The HIF-1α is a key link in gastric cancer for the tumor to tolerate hypoxia,the expressions of VEGF and HIF-1αmay serve as the important indexes to judge that the tumor is of high potential in invasion and metastasis,and the prognosis is unfavorable,.

关 键 词：胃肿瘤 血管内皮细胞生长因子 缺氧诱导因子-1Α 免疫组织化学 COX回归分析 

分 类 号：R735.2[医药卫生—肿瘤]