胰腺癌中低氧诱导因子-1α和轴突诱导因子4D的表达及其临床意义  

Expression of HIF-1α and Sema4D in pancreatic carcinoma and its clinical significance

作　　者：贾如江[1] 尹清臣[1] 王秀超[2] 侯丽艳[1] 许超 任利兵[1] 杨庚武[1] 

机构地区：[1]邯郸市中心医院普外一科,邯郸056102 [2]天津医科大学附属肿瘤医院胰腺肿瘤科,天津300060

出　　处：《重庆医科大学学报》2017年第11期1444-1448,共5页Journal of Chongqing Medical University

基　　金：河北省卫计委计划资助项目(编号:20150457)

摘　　要：目的:研究低氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)和轴突诱导因子4D(Semaphorin 4D,Sema4D)在胰腺癌组织中的表达,探讨两者之间的相关性及其临床意义。方法:采用免疫组织化学(immunohistochemistry,SP)法检测天津医科大学附属肿瘤医院和邯郸市中心医院82例胰腺癌组织和相应癌旁组织中HIF-1α和Sema4D的表达,采用Chi-square检验分析HIF-1α和Sema4D在不同组织中的表达差异,采用Chi-square检验分析HIF-1α和Sema4D与患者的性别、年龄、分化程度、肿瘤大小、胰腺癌分期、淋巴结转移、神经受侵、脉管内瘤栓等的相关性。HIF-1α和Sema4D在胰腺癌组织中的表达的相关性采用Mc Nemar检验分析其相关性。HIF-1α和Sema4D对胰腺癌患者生存率的影响分析采用Kaplan-meier法,生存曲线的比较采用Log-rank检验。Cox回归模型多因素分析方法,分析HIF-1α和Sema4D是否胰腺癌独立预后因素。结果:HIF-1α和Sema4D的阳性表达主要在细胞质内,呈棕黄色颗粒。HIF-1α和Sema4D在胰腺癌组织中的阳性表达率分别为52.4%(43/82)和51.2%(42/82),显著高于两者在癌旁组织的表达,差异有统计学意义(P<0.05)。HIF-1α的异常表达与胰腺癌分期(χ~2=11.398,P=0.000)、淋巴结转移(χ~2=20.341,P=0.000)、神经受侵(χ~2=23.478,P=0.000)、脉管内瘤栓(χ~2=8.281,P=0.000)相关,Sema4D的异常表达与胰腺癌分期(χ~2=7.212,P=0.007)、淋巴结转移(χ~2=60129,P=0.013)、神经受侵(χ~2=25.794,P=0.000)、脉管内瘤栓(χ~2=6.678,P=0.010)相关。HIF-1α和Sema4D的表达之间存在正相关性(κ=0.438,P=0.000)。单因素生存分析HIF-1α(χ~2=12.098,P=0.001)、Sema4D(χ~2=9.644,P=0.002)是影响胰腺癌的预后因素,Cox分析显示2者均不是影响胰腺癌的独立预后因素。结论:胰腺癌组织中存在HIF-1α和Sema4D表达的上调,两者具有明显相关性,与胰腺癌淋巴结转移、神经受侵、脉管内瘤栓有关,HIF-1α、Sema4D的表达可能提示胰腺癌患�Objective ：To study the expression and clinical significance of hypoxia inducible factor-1α（HIF-1α） and Sema4D in pan- creatic carcinoma and to explore its correlation and clinical significant. Methods ：The expression of HIF-1α and Sema4D in 82 cases of pancreatic cancer and the adjacent tissues were examined by immunohistochemistry（SP）. The differences in the different kinds of tissues were observed, and the relationship between the protein expression and the clinical pathological characteristics combined with the prognosis was analyzed. Results：The positive expressions of HIF-1α and Sema4D were mainly in the cytoplasm, presenting brown- ish yellow granules. HIF-1αand Sema4D expressions in pancreatic cancer tissues were 52.4% （43/82） and 51.2% （42/82）, which were significantly higher than those in precancerous tissues, with statistically significant differences, respectively （P〈0.05）. The abnormal expression of Hif-1α and Sema4D was in correlation with the tumor staging（x2=1 1.398,P=0.000）,lymph node metastasis（x2=20.341,P=-0.000）, neural invasion, embolus tumor（x2=23.478, P=0.000）. The level of Sema4D was significantly associated with HIF-1α expression （K=0.438, P=0.000）. HIF-1α（X2=12.098 ,p=0.001 ） and Sema4D（x2=9.644,P=0.002） were the prognostic factors in patients with pancreatic carcinoma. Cox analysis showedthat they were not independent prognostic factors of pancreatic cancer. Conclusion ： Upregulation of HIF- 1 alpha and Sema4D ex- pression in pancreatic cancer,both of which have significant correlation,both of which associated with Lymph node metastasis of pancreatic cancer, nerve invasion,vascular tumor thrombus, expression of HIF-1 alpha and Sema4D may suggest that pancreatic can- cer patients with late stage and poor prognosis.

关 键 词：胰腺癌 免疫组织化学 低氧诱导因子-1Α 轴突诱导因子4D 

分 类 号：R735.9[医药卫生—肿瘤]