颊黏膜鳞癌缺氧诱导因子-1α表达的临床意义

Expression and clinical significance of hypoxia-inducible factor-1α (HIF-1α) in squamous cell carcinoma of buccal mucosa

目的:探讨缺氧诱导因子-1α(hypoxia-induciblefactor-1α,HIF-1α)在颊黏膜鳞癌中的表达及其与临床病理因素的关系。方法:以免疫组化法分析45例颊黏膜鳞癌HIF-1α的表达,同时,明确HIF-1α表达与性别、年龄、病史、肿瘤直径、病理分级、区域淋巴结转移、复发、临床分期、浸润深度、核分裂数、淋巴细胞浸润程度等指标的关系。结果:HIF-1α表达阳性者31例(69%),阴性者14例(31%)。HIF-1α的阳性表达主要分布在癌巢的中央部分。肿瘤直径、区域淋巴结转移和临床分期这3个指标与HIF-1α阳性表达程度有关:肿瘤直径较大者(T3+T4)明显高于肿瘤直径较小者(T1+T2)(P=0.008);已出现区域淋巴结转移者明显高于未出现转移者(P=0.037);高临床分期者(III+IV期)高于低分期者(I+II期)(P=0.011)。另外,HIF-1α表达呈阳性的颊黏膜鳞癌的肿瘤厚度为4.87mm,明显高于呈阴性表达者3.81mm(P=0.046)。经Logistic回归分析,证明随着生存月数的增加,HIF-1α阳性表达的程度下降。结论:颊黏膜鳞癌HIF-1α表达与肿瘤直径有关;HIF-1α的高表达者既易出现区域淋巴结转移,也具有较高的临床分期。另外,HIF-1α也可作为一个判断颊黏膜鳞癌术后生存时间的指标。

Objective：To study the expression and clinical significance of hypoxia-inducible factor-1α （ HIF-1α） in squamous cell carcinoma of buceal mueosa. Methods ：45 cases of paraffin embedded samples of squamous cell carcinoma of buccal mucosa were examined with HIF-1α antibody by immunohistoehemistrieal method. The relationship between HIF-1α expression and clinico-pathological factors such as sex, age, duration of tumour, T classification, （tiffer- entiation, lymph node metastasis in the neck, recurrence, clinic classification, tumour thiekness, the number of mito- sis and the degree of lymphocyte invasion was analyzed. Results ：The positive expression of HIF-1 e~ was found in 31 out of the 45 cases（69% ）. HIF-1 e~ positive reaction was predominately located in the center of tumour nest. While analy- zing ellnlco-pathologleal factors, only T classification （ between T1 ＋ T2 and T3 ＋ T4, P = 0. 008 ） , lymph node metastasis of the neck （ P = 0. 037 ） and elinle classification （ between stage Ⅰ ＋ Ⅱ and Ⅲ＋ Ⅳ, P = 0.011 ） showed a significant correlation with HIF-1α expression. HIF-1α possitlve expression is higher in T3 ＋ T4（ d =4.87 ram） than that in T1 ＋ T2（3.81 mm） （P =0. 046）. Logistic analysis showed that the longer the patients lived after operation, the less the HIF-1 α positive expression. Conclusions：HIF-1α positive expression in squamous cell carcinoma of the buccal mucosa correlates to T classification, lymph node metastasis of neck, clinical classification and survival.