HIF-1α表达在胃癌中的作用及其与胃癌术后复发的相关性

Correlation between gastric HIF-1α expression and gastric cancer recurrence

目的:探讨缺氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)在胃癌中的作用及其与胃癌术后复发的相关性与影响因素.方法:选取行根治切除手术后复发的80例胃癌患者为研究对象,另选取行根治切除手术后经随访5年以上无复发的50例胃癌患者为对照组,采用免疫组织化学法测定两组HIF-1α、血管内皮生长因子(vascular endothelial growth factor,VEGF)阳性表达情况,采用单因素及Cox风险模型对影响胃癌患者预后的危险因素进行分析,HIF-1α与VEGF相关性采用Spearman相关分析.结果:观察组胃组织中HIF-1α、VEGF表达阳性率分别为77.50%、73.75%显著高于对照组12.00%、10.00%.经单因素分析可知,分化程度、浸润程度、淋巴结是否转移、血管侵袭性、TNM临床分期、VEGF表达情况与胃癌HIF-1α阳性表达相关.经Spearman相关分析可知HIF-1α与VEGF呈正相关(r=0.458,P=0.000).HIF-1α阳性组1年生存率为45.16%,平均生存时间为8.62 mo±2.32 mo显著低于阴性组1年生存率77.77 mo及平均生存时间18.96mo±3.14 mo.经Cox风险模型可知,HIF-1α与VEGF阳性表达是影响胃癌患者预后的独立危险因素.结论:HIF-1α高水平表达与胃癌复发及血管生成具有密切的关系,其可作为胃癌术后复发及预后的评价测指标.

AIM： To investigate the relationship between hypoxia inducible factor -1α （HIF-1α） expression and gastric cancer recurrence and to analyze factors affecting HIF-1α expression in gastric cancer. METHODS： Eighty patients with gastric cancer recurrence after radical resection were included in the study, and 50 patients without recurrence after radical resection for more than 5 year were selected as a control group. The expression of HIF-1α and VEGF was compared between the two groups. Risk factors for gastric cancer were analyzed with univariate and Cox proportional hazards models. The correlation between HIF-1α and VEGF expression was investigated by Spearman correlation analysis. RESULTS： The positive rates of HIF-1α （77.50% vs 12.00%） and VEGF （73.75% vs 10.00%） expression were higher in the recurrence group than in the control group. The degree of differentiation, depth of invasion, lymph node metastasis, vascular invasion, TNM clinical stage, VEGF expression were factors affecting HIF-1α expression in gastric tissue. There was a positive correlation between HIF-1α and VEGF expression （r = 0.458, P = 0.000）. The 1-year survival rate （45.16% vs 77.77%） and average survival time （8.62 ± 2.32 vs 18.96 ± 3.14） were significantly lower in the HIF-1α-positive group than in the HIF-1α-negative group. HIF-1α and VEGF expression were independent prognostic factors for gastric cancer. CONCLUSION： HIF-1α expression is closely related to recurrence of gastric cancer and tumor angiogenesis, and can be used as a parameter for assessing gastric cancer recurrence and prognosis.