HIF-1α、VEGF、CD105-MVD在子宫内膜腺癌中的表达及意义

Expressions and its clinical significance of HIF-1α, VEGF, CD105-MVD in the endometrial cancer

目的:探讨转录因子缺氧诱导因子-1α(HIF-1α)、血管内皮细胞生长因子(VEGF)、CD105标记的微血管密度(CD105-MVD)在子宫内膜腺癌组织中的表达状况以及与肿瘤血管生成、预后之间的关系。方法:免疫组化法检测56例子宫内膜腺癌、18例子宫内膜不典型增生、20例正常子宫内膜组织中HIF-1α、VEGF蛋白及CD105-MVD的表达。结果:在正常子宫内膜、宫内膜不典型增生、子宫内膜腺癌中HIF-1α、VEGF蛋白表达阳性率分别为45%、28%、61%及60%、72%、89%,CD105-MVD分别为21.6±11.5、27.9±13.7、47.7±12.8。三者分别在不同组织中比较差异均有显著性意义(P<0.05)。HIF-1α、VEGF蛋白与临床病理特征无相关性,但HIF-1α阳性患者的5年生存率低于阴性患者(P<0.05)。CD105-MVD与浸润肌层深度、手术-病理分期有关(P<0.05),高CD105-MVD患者的5年生存率低(P=0.0767)。在子宫内膜腺癌中HIF-1α表达与CD105-MVD呈正相关(r=0.282,P=0.035),与VEGF呈正相关(r=0.355,P=0.007)。结论:HIF-1α在子宫内腺癌中存在着过表达,与不良的预后有关。HIF-lα通过促进肿瘤血管生成,在子宫内膜腺癌的发生发展中起着重要作用。

Objective To investigate the expression of HIF-1α, VEGF and CD105-MVD in endometrial adenocareinoma and their relationship with tumor angiogenesis, several histopathologic parameters and prognosis. Method HIF-1α,VEGF proteins and CD105-MVD were studied immunohistochemically in 56 patients with endometrial adenocarcinoma, 20 with normal endometria and 18 with atypia hyperplasia. Results The positively expressed rates of HIF-1α and VEGF in normal endometria, atypia hyperplasia, and endometrial cancer were 45%, 28%, 61% and 60%, 72%, 89%, respectively. The expression levels of CD105-MVD were 21.6 ± 11.5, 27.9 ± 13.7 and 47.7± 12.8, respectively. There were significant differences between each group （P 〈 0.05）. Increased HIF-1α and VEGF expression has no association with clinic pathological parameters. There was a significant relationship between HIF-1α overexpression and a poor prognosis （P 〈 0.05）. The levels of CD105-MVD in endometrial cancer was significantly correlated with the clinical stage and the depth of myometrial invasion. There was a marginal associateion of high CD105-MVD and a poor prognosis （P=0.076 7）. In the cases of endometrial cancer, there was a positive correlation between expression of HIF-1α and VEGF （r=0.355,P=0.007）, HIF-1α and CD105-MVD （r=0.282,P=0.035）. Conclusions The up-regulation of HIF-1α is a common event in endometrial adenocareinomas. The high-expression of HIF-1α may play an important role in the prognoseis of endometrial carcinoma via increased tumour angiogenesis.