缺氧诱导因子1α在乳头状肾细胞癌中的表达及其与预后的关系  

Expression of HIF-1αand its relationship with prognosis in papillary renal cell carcinoma

作　　者：芮文斌[1] 徐达[1] 祝宇[1] 吴瑜璇[1] 王浩飞[1] 汪成合[1] 袁菲[2] RUI Wenbin;XU Da;ZHU Yu;WU Yuxuan;WANG Haofei;WANG Chenghe;YUAN Fei(Department of Urology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Pathology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院泌尿外科,上海200025 [2]上海交通大学医学院附属瑞金医院病理科,上海200025

出　　处：《诊断学理论与实践》2021年第3期265-270,共6页Journal of Diagnostics Concepts & Practice

摘　　要：目的:检测缺氧诱导因子1α(hypoxia-inducible factor-1ɑ,HIF-1α)在乳头状肾细胞癌(papillary renal cell carcinoma,PRCC)组织中的表达情况,分析其与微血管密度(microvessel density,MVD)间的关系,并探讨HIF-1α与患者预后间的关系。方法:应用免疫组织化学(免疫组化)技术检测PRCC组织和癌旁肾组织(对照)中HIF-1α及MVD表达,分析二者之间的相关性。采用Kaplan-Meier法和Logrank法对患者的生存数据进行分析,对有意义的因素行Cox模型多因素回归分析。结果:PRCC组织中HIF-1α的阳性表达率为42.17%(35/83),其中Ⅰ型、Ⅱ型PRCC组织中HIF-1α阳性表达率分别为32.65%、55.88%,二者间差异有统计学意义(P=0.035)。Ⅱ型PRCC组织中的MVD高于Ⅰ型PRCC(40.74个/高倍镜比25.63个/高倍镜),在Ⅰ型和Ⅱ型PRCC中,HIF-1α的表达均与MVD呈正相关(γ=0.65)。83例PRCC患者的5年生存率为89.16%(74/83),13例死亡的病例中,10例为Ⅱ型PRCC,采用KaplanMeier生存曲线分析显示,Ⅰ型PRCC患者的预后好于Ⅱ型PRCC(5年总体生存率87.8%比76.5%,P<0.05)。单因素分析显示,肾细胞癌Fuhrman核分级Ⅲ~Ⅳ级、肿瘤发生远处转移和HIF-1α阳性表达是PRCC患者预后不良的危险因素;多因素分析显示,Ⅱ型PRCC、Fuhrman核分级Ⅲ~Ⅳ级、肿瘤远处转移及HIF-1α阳性表达是PRCC预后不良的因素。结论:相对于Ⅰ型PRCC,HIF-1α在Ⅱ型PRCC组织中的阳性率更高,其阳性表达是PRCC患者预后不良的因素。Objects:To investigate the expression of hypoxia inducible factor-1ɑ(HIF-1ɑ)in papillary renal cell carcinoma(PRCC)and its relationship with microvessel density so as to explore the correlation of HIF-1ɑexpression with prognosis in PRCC patients.Methods:Immunohistochemistry was used to detect the expression of HIF-1ɑin PRCC and para-carcinoma tissue and the relationship between expression of HIF-1ɑand MVD was analyzed.Survival data were evaluated with Kaplan-Meier and Log-rank method,and the significant factors were further analyzed with Cox model multivariate regression analysis.Results:The positive expression rate of HIF-1ɑwas 42.17%(35/83),and the positive expression rates in typeⅠand type II PRCC were 32.65%and 55.88%,respectively.The MVD in typeⅡPRCC was higher than that in typeⅠPRCC(40.74/HP vs 25.63/HP),and HIF-1ɑexpression was positively correlated with MVD(γ=0.65).The 5-year survival rate of 83 PRCC patients was 89.16%(74/83),and of the 13 death cases,10 cases were typeⅡPRCC.The Kaplan-Meier survival curve analysis showed that typeⅠPRCC had a better prognosis than typeⅡ.Univariate analysis revealed that Fuhrman gradeⅢ-Ⅳ,occurrence of distant metastasis and HIF-1ɑexpression were risk factors for prognosis in PRCC patients(P<0.05).Multivariate analysis showed that HIF-1ɑexpression,Fuhrman grade,subtype of PRCC and distant metastasis were risk factors for poor prognosis.Conclusions:HIF-1ɑexpression is higher in typeⅡPRCC than in typeⅠPRCC,and HIF-1ɑexpression is a risk factor for poor prognosis in PRCC patients.

关 键 词：乳头状肾细胞癌 缺氧诱导因子1ɑ 微血管密度 预后 

分 类 号：R737.1[医药卫生—肿瘤]