HIF-1α的表达与胃癌根治性切除术后复发的关系

Relationship between the expression of HIF-1α and the recurrence of gastric cancer after surgery

目的探究缺氧诱导因子(HIF-1α)的表达与胃癌根治性切除术后复发的关系。方法选择2005年3月-2009年4月在河北大学附属医院行胃癌根治性切除术的106例患者作为研究对象,其中5年内复发者63例(复发组),未复发者43例(对照组)。复发组和对照组的胃癌组织切片均进行HIF-1α、血管内皮生长因子(VEGF)和CD34的免疫组织化学染色。对HIF-1α阳性率在两组的比较行χ2检验。采用Kaplan-Meier法和Log-rank检验复发患者的生存情况。结果复发组的HIF-1α阳性表达率显著高于对照组(χ2=10.995,P<0.001);复发组中,HIF-1α阳性率与胃癌的分化程度、浸润深度、淋巴结转移、腹水、肿瘤血管侵袭、TNM分期、VEGF表达均有相关性(P<0.05);复发组的总体生存期为(13.9±2.7)个月,1年生存率为31.4%,其中HIF-1α阴性的患者生存期(20个月)高于HIF-1α阳性者(10个月),HIF-1α阴性的患者1年生存率(51.4%)高于HIF-1α阳性(21.6%)。结论HIF-1α对肿瘤血管的生成有重要作用,可作为评估胃癌术后复发的指标。

Objective To explore the relationship between the expression of hypoxia-inducible factor-1α （HIF-1α） and the recurrence of gastric cancer after surgery. Methods One hundred and six patients with gastric cancer who re- ceived radical resection from Mar. 2005 to Apr. 2009 in the Affiliated Hospital of Hebei University were selected as the objectives, including 63 eases who had a relapse in the 5 years＇ follow-up （recurrence group） and 43 cases without re- currence （control group）. The expression of HIF-1α, vascular endothelial growth factor （VEGF） and CD34 were detec- ted by immunohistochemistry streptavidin-peroxidase staining. Chi-square was performed for the correlation analysis on the positive rates of HIF-1α between two groups with different clinical pathological features. Kaplan-Meier method and Log-rank test were used for the analysis of survival condition of the recurrence group. Results The positive rate of HIF- 1α expression of recurrence group was higher than the control group （X^2 = 10. 995, P 〈 0. 001 ）. In recurrence group, the positive rate of HIF-1α was significantly related to the degree of gastric cancer differentiation, invasion, lymph node metastasis, ascites, vascular invasion, TNM stage and the expression of VEGF （P 〈 0.05）. The total survival period of recurrence was （13.9 ± 2.7）months and the one-year survival rate was 31.4%. Of which, the overall survival period and one-year survival rate of cases with negative HIF-1α expression were higher than those with positive HIF-1α expres- sion （20 months vs 10 months; 51.4% vs 21.6% ）. Conclusion HIF-1α plays an important role in the angiogenesis of the tumor and it could be an indicator of gastric cancer recurrence.