HIF-1α蛋白与食管鳞癌关系的荟萃分析

A Meta-analysis of Relationship Between HIF-1α Expression and Esophageal Squamous Cell Carinoma

[目的]探讨乏氧诱导因子-1α（HIF-1α）在食管鳞癌（ESCC）中的表达水平及与其临床病理特征之间的关系。[方法]检索Pubmed、EMBASE、Cochrane Library、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库等,同时追查纳入文献的参考文献,纳入有关HIF-1α与ESCC关系的临床试验。采用Stata11.0软件进行统计学分析。[结果]共纳入16篇文献,1261例ESCC患者。Meta分析结果显示,HIF-1α在ESCC患者中的阳性表达水平明显增高（OR=33.11,95%CI：11.19~92.04）。临床病理结果显示,HIF-1α在ESCC低分化组与中高分化组的表达差异无统计学意义（P〉0.05）。但HIF-1α表达在不同的T分期、淋巴结转移以及临床分期中差异均具有统计学意义（P〈0.05）。相关分析显示,HIF-1α与VEGF蛋白阳性率具有相关性。HIF-1α阳性表达者放化疗疗效显著低于HIF-1α阴性表达者（P〈0.05）。进一步生存分析显示,HIF-1α阳性表达的患者2年生存率明显低于阴性表达者（P〈0.05）。[结论]HIF-1α在ESCC患者中高表达,增加了其恶性行为的发生危险,降低了ESCC患者放化疗疗效、2年生存率,同时HIF-1α与VEGF在ESCC中表达也有一定的相关性。

[Purpose ] To investigate the expression of Hypoxia-inducible factor-1α （HIF-lα in pa- tients with esophageal squamous cell carcinoma （ESCC） and its relationship with elinieopathological features. [Methods] Studies assessing clinical or prognostic significance of HIF-1α expression in patients with ESCC published until December 2011 were selected. A meta-analysis was performed to clarify the impact of HIF-1α expression on clinieopathological parameters,histologie response to chemotherapy or overall survival （OS） in ESCC. [Resuhs] A total of 16 studies were recruited. The positive rate of HIF-1α expression was significantly different between ESCC group and control group （OR=33.11,95%CI：11.19-92.04）. There was no significant difference between low differentiation group and high differentiation group （P〉0.05）. However,there were significant differences between stage T3-T4 vs Ti-Tz,lymph node metastasis vs non-lymph node metastasis, stage III-IV vs I -I ,re- spectively （P〈0.05）. HIF-1α expression positively correlated with vascular endothelial growth factor expression （P〈0.05） . The patients overexpressed HIF-loL had a worse response to chemoradiotherapy and a lower 2-year survival （P〈0.05）. [Conclusion] HIF-1α might play an important role in the progress of ESCC ,overexpression of HIF-1α correlates with not only the depth of invasion,lymph node metastasis and clinic stage but also the reduced response to chemoradiotherapy and OS.