缺氧诱导因子-1α在胃癌组织中的表达与胃癌术后复发的关系  

Correlation between the expression of hypoxia-inducible factor-let in the tissue of gastric cancer and the recurrence of the gastric cancer after surgery

作　　者：徐桂芳[1] 周志华[2] 吴寒[1] 徐新运[3] 汪灏[4] 管文贤[4] 邹晓平[1] 

机构地区：[1]南京大学医学院附属鼓楼医院消化内科,210008 [2]解放军第101医院病理科 [3]南京大学医学院附属鼓楼医院病理科,210008 [4]南京大学医学院附属鼓楼医院胃肠外科,210008

出　　处：《中华消化杂志》2013年第7期456-459,共4页Chinese Journal of Digestion

基　　金：国家自然基金（81000964、81201909）;南京市医学科技发展项目（QYK11166）;南京市卫生青年人才工程

摘　　要：目的研究缺氧诱导因子-1α（HIF-1α）在胃癌组织中的表达及其与胃癌术后复发的关系。方法以60例行根治性切除、随访资料完整但术后复发的胃癌患者为复发组，以48例同期收治并随访5年以上无复发的胃癌患者为对照组。对复发组和对照组的胃癌组织切片进行HIF-1α、CD34和血管内皮生长因子（VEGF）免疫组织化学链霉素抗生物素蛋白一过氧化物酶（S-P）法染色。HIF—I“阳性率与临床病理特征间关系的比较行卡方检验和Spearman相关分析。采用Kaplan-Meier法和Log—rank检验分析复发组的生存情况。采用单因素分析和Cox回归模型分析胃癌预后的独立影响因素。结果复发组中，胃癌分化程度较高、浸润较深、有淋巴结转移、有腹水、有血管浸润、TNM分期较晚、VEGF阳性表达者的HIF-1α阳性率较高，差异均有统计学意义（X^2=4．781、6．59i、6．567、5．138、5．320、5．881、7．365，P均〈0．05）。复发组HIF_1d阳性率与VEGF阳性表达和微血管密度（MVD）相关（r=0．350和0．317，P均〈0．05）。复发组HIF-1α阳性率[78．3％（47／60）]高于对照组E58．3％（28／48）]，差异有统计学意义（X^2=5．027，P〈0．05）。复发组的总体生存期为9个月，i年生存率为30．0％；其中HIF-Ie阴性者的总体生存期和1年生存率分别为18个月和53．8％，HIF-1α阳性者则分别为8个月和21．3％。HIF-1α表达是胃癌预后的独立影响因素（OR=2．166，95％CI：1．183～3．965）。结论HIF-1α表达在胃癌血管生成过程中起重要作用，与胃癌复发密切相关，其表达可作为判断胃癌复发及预后的指标。Objective To explore the correlation between the expression of hypoxia-inducible factor-1α （HIF-1α） in the tissue of gastric cancer and the recurrence of gastric cancer after surgery. Methods A total of sixty patients with gastric cancer who received curative gastrectomy with complete follow-up data and recurrence after the surgery were taken as recurrence group. At same period, 48 patients with gastric cancer treated and followed up for five years without recurrence were set as control group. The expressions of HIF-1α, CD34 and vascular endothelial growth factor （VEGF） in the gastric tissue section of recurrence group and control group were detected by immunohistochemistry streptavidin-peroxidase （ S-P ） staining. Chi-square test and Spearman correlation analysis were performed for the correlation analysis between the positive rates of HIF-1α and clinical pathological features. Kaplan-Meier method and Log-rank test were used for the analysis of survival condition in recurrence group. The independent prognostic factors of gastric cancer were analyzed by univariate analysis and Cox regression model. Results In recurrence group, the positive rate of HIF-1α expression was higher in cases with higher degree of gastric cancer differentiation, deeper invasion, lymph node metastasis, ascites, vascular invasion, lower TNM-stage and positive expression of VEGF. The differences were statistically significant （X^2 =4. 781, 6. 591, 6. 567, 5. 138, 5. 320, 5. 881 and 7. 365,all P〈0.05）. The positive rate of HIF-1α expression of recurrence group was correlated with the positive expression of VEGF and mierovascular density （MVD） （r=0. 350 and 0. 317, both P%0.05）. The positive rate of HIF-1α expression of recurrence group （78.3%, 47/60） was higher than that of control group （58.3 %, 28/48） and the difference was statistically significant （X^2=5. 027, P〈0.05）. The overall survival period of recurrence was nine months and one-year survival rate was 30.0 %. Of which, the overall survi

关 键 词：胃肿瘤 缺氧诱导因子1α亚基 胃切除术 肿瘤复发 局部 预后 

分 类 号：R735.2[医药卫生—肿瘤]