肝癌组织VEGF、HIF-1α和MMP-2表达的临床研究

The expression of VEGF,HIF-1α and MMP-2 in hepatocellular carcinoma

目的研究VEGF、HIF-1α和MMP-2在肝癌组织中表达的临床意义。方法55例病理证实肝癌标本,免疫组化检测VEGF、HIF-1α和MMP-2的表达,分析上述指标与临床发病特征、术后生存时间、复发及转移的关系。结果肝癌术后1、2年累积生存率及无瘤生存率分别为89.1%、61.8%和52.7%、30.9%。单因素分析,转移、原发灶数目、肿瘤包膜、大小、VEGF、HIF-1α和MMP-2表达影响术后生存时间;Cox多因素分析,转移和肿瘤包膜对生存时间的影响差异有统计学意义。VEGF、HIF-1α和MMP-2表达与转移及肿瘤包膜密切相关。MMP-2与术后2年无瘤生存密切相关(P=0.001)。VEGF、HIF-1α和MMP-2表达相互促进。结论VEGF、HIF-1α和MMP-2过表达与肝癌术后复发转移密切相关,联合分析三者的表达对肝癌手术治疗的预后判断有更大指导价值。

Objective To explore the clinical significance of vascular endothelial growth factor （VEGF）, hypoxia-inducible factor-lot （HIF-1a） and matrix metalloproteinase-2 （MMP-2） in surgical specimens from patients with hepatocellular carcinoma （HCC）. Methods Fifty five cases of HCC patients undergoing tumor resection were retrospectively analyzed. All of the tumor were proved as HCC with pathologic examination.The tumor biopsy samples were detected by immunohistochemistry. Expressing intensities of VEGF,HIF-1a and MMP-2 were qualitatively analyzed.The patients＇survival time and conditions of recurrence and metastasis were followed up within 2 years after resection. Relationship between the expression of VEGF, HIF-1a and MMP-2 and the prognosis were analyzed. Results The 1-, 2-year overall and tumor-free survival rate were 89. 1% and 61.8% ,52. 7% and 30. 9% ,respectively, With a single factor analysis model,the factors affected survival time were metastasis,number of primary focus,capsule,tumor size and the expression of VEGF,HIF-1a and MMP-2. However,with the Cox regression analysis model,only metastasis and capsule were the factors significantly related to survival time. And the expression of VEGF, HIF-1a and MMP-2 were closely correlated to metastasis and capsule. Progression-free survival rate within 2 years after surgical therapy was closely correlated to the expression of MMP-2 （P =0.001 ）. VEGF,HIF-1a and MMP-2 induced and enhanced each other. Conclusion VEGF, HIF-1a and MMP-2 overexpression closely correlate to metastasis and recurrence of HCC. VEGF, HIF-1a and MMP-2 together has greater instructive significance for the judgement of prognosis of HCC after surgical therapy.