肺癌患者血管内皮生长因子表达与缺氧及肿瘤生物学行为和预后的关系

Expression of vascular endothelial growth factor in patients with pulmonary carcinoma and relationship with biological behavior of hypoxia and tumor and prognosis

目的:探讨血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)在肺癌患者的表达与缺氧诱导因子-1α(hypoxia-induciblefactor-1α,HIF-1α)及肿瘤生物学行为和预后的关系。方法:随机选取青岛大学医学院附属医院1985-01/1990-12经手术切除的具有完整随访记录的75个肺癌标本,术前均未行放射治疗或应用抗肿瘤药物治疗,采用免疫组化PV-9000法检测VEGF和HIF-1α的表达。结果:不同组织学分级、不同术后生存时间组间VEGF表达强度的差异均有极显著性意义(Hc=17.019,17.616;P=0.000)。其表达强度的差异在淋巴结有、无转移组间亦有极显著性意义(Z=-3.319,P=0.001)。在不同组织病理类型间,HIF-1α的表达差异有极显著性意义(Hc=14.021,P=0.001),小细胞肺癌的表达强度显著高于鳞、腺癌(P=0.000,0.012),而鳞、腺癌间的表达差异无显著性意义(P=0.113)。其阳性强度增加亦与肺癌细胞恶性程度(Hc=29.470,P=0.000)、易发生淋巴结转移(Z=-2.576,P=0.010)及预后不良(Hc=20.681,P=0.000)有关。肺癌组织中VEGF与HIF-1α的表达强度呈极显著性正相关(τ=0.564,P=0.000)。结论:VEGF的表达强度与缺氧程度密切相关;VEGF和HIF-1α的表达均与肺癌细胞分化程度、淋巴结转移及患者生存期有关。

AIM:To investigate the expression of vascular endothelial growth factor(VEGF) in patients with pulmonary carcinoma and its relationship with hypoxia inducible factor 1α (HIF 1α ),tumor biological behavior and prognosis.METHODS:Seventy five specimens of pulmonary carcinoma,resected by operation during January 1985 and December 1990,who did not received preoperative radiotherapy or anti tumor drug therapy,and with complete follow up record were randomly selected from Medical School Hospital of Qingdao University.The expression of VEGF and HIF 1α was detected immunohistochemically by PV 9000 method.RESULTS:The expressive intensity of VEGF was highly and significantly different at different pathological grading,in different postoperative survival time groups(Hc=17.019,17.616,P=0.000) and between the two groups with lymph node metastasis or not(Z=- 3.319,P=0.001).The expressive intensity of HIF 1α was very significantly different among different pathological types(Hc=14.021,P=0.001).The expressive intensity of HIF 1α was significantly higher in small cell lung cancer(SCLC) than that in squamous carcinoma and adenocarcinoma(P=0.000,0.012),while that was insignificant different between squamous carcinoma and adenocarcinoma(P=0.113).The increase of expressive intensity of HIF 1α was correlated with malignant degree of pulmonary carcinoma cells(Hc=29.470,P =0.000),easily happened lymph node metastasis(Z=- 2.576,P =0.010) and poor prognosis(Hc=20.681,P=0.000).There was a highly positive correlation between the expression of VEGF and HIF 1α (τ =0.564,P=0.000).CONCLUSION:The expressive intensity of VEGF is closely correlated with the extent of hypoxia.The expression of VEGF and HIF 1α is related to differentiation degree of pulmonary carcinoma cell,lymph node metastasis and postoperative survival time.VEGF and HIF 1α might serve as important parameters in evaluating biological behavior and prognosis of pulmonary carcinoma.