HIF-1α及STAT3联合预测异时性结直肠癌肝转移

The Prognostic Value of HIF-1α Combined with STAT3 for Early Predicting the Heterochrony CRLM in Colorectal Cancer

目的：研究缺氧诱导因子1α（HIF-1α）及信号传导转录激活因子3（STAT3）联合早期预测异时性结直肠癌肝转移（CRLM）。方法：68例初诊结肠癌患者及35例结肠息肉患者（对照组）均在内镜下取活体组织,采用Western-blot测定HIF-1α及STAT3的表达;结肠癌患者随访6~22月,比较发生CRLM组患者和单纯结肠癌（非CRLM组）患者临床资料,比较CRLM组、非CRLM组及结肠息肉组HIF-1α和STAT3的表达,同时分析HIF-1α和STAT3不同组合时,CRLM组和非CRLM组的发生率。结果：除淋巴结转移因素外,年龄、性别、肿瘤直径、肿瘤形态、分化程度、TNM分期、脉管侵犯等因素在CRLM组及无CRLM组间差异无统计学意义（P〉0.05）;STAT3及HIF-1α的表达趋势相同（CRLM组〉非CRLM组〉结肠息肉组）;STAT3、HIF-1α同时过表达时,患者出现CRLM的几率为60%,均未过表达时,CRLM的几率仅为10%。结论：结直肠癌患者治疗前肿瘤组织的STAT3、HIF-1α蛋白表达水平联合分析,有助于预测患者未来发生CRLM的几率。

Objective： To evaluate the diagnostic and prognostic value of HIF- loL combined with STAT3 for early predicting the heterochrony coloreetal liver metastases （CRLM）. Methods： A total of 68 patients with preliminary diagnosis of colon carcinoma as experimental group and 35 patients with polyp of colon as control group were enrolled in this study. The tissue samples of all patients were collected by endoscope, and the protein expression levels of HIF - lα and STAT3 were determined by western - blot. After 6 ~ 22 months follow up for colon cancer patients, the clinical data of CRLM group and non - CRLM group were compared and analyzed. The protein expression levels of HIF - 1α and STAT3 in CRLM group, non - CRLM group and control group were compared and analyzed. Meanwhile, the incidence rate of CRLM and non - CRLM was analyzed in terms of different combina- tion of HIF - 1 α and STAT3 protein expression. Results： There was no significant difference be- tween non- CRLM and CRLM group in gender, age, diameter of tumor, tuberiform, differentiation level, TNM stage and invasion of vessel except lymph node metastasis （ P 〉 0.05 ）. The expression level of STAT3 and HIF - lα was highest in CRLM group, next was in non - CRLM group, and low- est in polyp of colon group. In addition, the incidence of CRLM in the patients with simultaneous overexpression of HIF -1 α and STAT3 was 60.0% compared with 10% in patients with simultane- ous low expression of HIF - 1 α and STAT3. Conclusion： Combined analysis of HIF - 1 α and STAT3 protein expression level in patients with colorectal cancer is helpful to early predicting the in- cidence of CRLM.