宫颈癌不同临床分期放疗抗拒与缺氧诱导血管新生的关系

The relationship between resistance after radiotherapy and hypoxia-induced angiogenesis at different clinical stages of cervical squamous cell carcinoma

目的探讨不同临床分期的宫颈癌放疗抗拒与肿瘤缺氧诱导血管新生的关系及意义。方法选取91例不同临床分期的宫颈鳞癌放疗患者,采用免疫组织化学SP法检测乏氧细胞诱导因子(HIF-1α)、血管内皮生长因子(VEGF),并用CD105标记新生微血管密度(MVD)。结果随着临床分期的加重,肿瘤的放疗抗拒增大。VEGF、HIF-1α在宫颈鳞癌Ⅱb～Ⅳ期放疗后抗拒的阳性表达率升高,差异有统计学意义(P<0.05)。HIF-1α、VEGF与MVD在不同临床分期之间存在正相关,且随临床分期的加重,MVD的计数逐渐增加,差异有统计学意义(P<0.05)。结论随着宫颈鳞癌的临床分期加重,肿瘤的放疗抗拒加重,HIF-1α、VEGF、MVD的表达与之相关,可作为宫颈鳞癌放疗后判断预后的可靠依据。

Objective To investigate the relationship and significance between radiotherapy resistance and angiogenesis induced by hypoxia in patients with cervical squamous cell carcinoma （SCC） at different clinical stages. Methods 91 patients with cervical SCC at different clinical stages who were treated by radiotherapy were enrolled in the investigation. The immunohistrochemical assay was used to detect the expressions of HIF-1α, VEGF,COX-2, and microvessel density （MVD） was marked by CDl05. Results The radiotherapy resistance of cervical SCC was increased with the aggravation of clinical stages. The positive expression rates of VEGF, HIF-1α at Ⅱb～Ⅳ stages after radiotherapy were significantly increased （ P 〈 0.05 ）. There was a positive correlation between HIF-1α, VEGF and MVD at different clinical stages, furthermore, the count of MVD was gradually increased with the aggravation of clinical stages, and there was a significant difference （ P 〈 0. 05 ）. Conclusion The radiotherapy resistance of cervical SCC is increased with the aggravation of clinical stages. There is a positive correlation between HIF-1α, VEGF, MVD and different clinical stages, which can be used as the reliable evidence for evaluating the prognosis of patients with cervical SCC after radiotherapy.