缺氧诱导因子1a在胃肠道间质瘤中的表达及其与血管内皮细胞生长因子的相关性

Expression and significance of HIF-1a and VEGF in gastrointestinal stromal tumors

目的探讨缺氧诱导因子1a(HIF-1a)和血管内皮细胞生长因子(VEGF)在胃肠间质瘤(GISTs)中的表达及其在预后判断中的价值。方法采用免疫组织化学S-P法检测86例GISTs组织中HIF-1a和VEGF的表达情况。结果 HIF-1a和VEGF在GISTs中的阳性表达率分别为73.3%(63/86)和72.1%(62/86),其表达呈正相关性(P<0.05)。HIF-1a和VEGF表达与胃肠道间质瘤的组织学分级、肿瘤直径、浸润转移和核分裂数有关(P<0.05),而与患者年龄、性别、肿瘤原发部位无关(P>0.05)。HIF-1a、VEGF在极低和低危险、中度危险和高危险及肿瘤直径<2cm和肿瘤直径>5cm组间差异有统计学意义(P<0.05),其阳性表达率随恶性程度的增加和肿瘤直径的增大而增加(P<0.05),在有浸润转移和核分裂数≥5/50HP组中的表达明显高于无浸润转移和核分裂数<5/50HP组中的表达(P<0.05)。HIF-1a和VEGF阳性患者的5年生存率均显著低于阴性组患者,差异有统计学意义(P<0.05)。结论 HIF-1a和VEGF在GISTs中的表达有联合倾向,可能提示肿瘤的恶性程度及其预后,有可能作为判断预后的标志物。

Objective To explore the expression and the value of HIF-la and VEGF in judgement of the prognosis of gastrointestinal stromal tumors （GISTs）. Methods The expression of HIF-la and VEGF protein was examined in 86 GISTs by immunohistochemistry S-P methods. Results There was a pos- itive correlation between the expression of HIF-la and VEGF（ P 〈 O. 05 ）. The positive expression rate of HIF-1 a and VEGF was 73.3% （63/86）, and 72. 1% （62/86） respectively, which was related with histolo- gicial grade, tumor diameter, infiltration and metabasis, nuclear division rating of GISTs （ P 〈 O. 05 ） , but had no relationship with patients＇age, gender,initial occurring position of the tumor（P 〉 0. 05 ）. There was sta- tistically significant difference in the expression of HIF-la and VEGF in the following groups： among the three classes of very low-risk and low-risk,middle-risk,high-risk, bewteen the diameter 〈 2cm and 〉 5cm （P 〈 0.05）, The more malignant level and larger diatheter the more highly positive expression rate （ P 〈 O. 05）. The positive expression in the groups with infiltration and metastasis and nuclear division≥5/5OHP is significantly higher than the groups without infiltration and metastasis and nuclear division 〈 5/50HP（ P 〈 O. 05）. The 5-year survival rates of patients with positive expressions of HIF-la and VEGF were significant- ly lower than those with negative expressions of HIF-1 a and VEGF （ P 〈 0. 05 ）. Conclusion The expres-sion of HIF-la had a significant correlation with VEGF. HIF-la and VEGF expression was closely related with the prognosis of GISTs, and can serve as important predictors for survival. Meanwhile a new molecular therapy is suggested according to our experimentation.