缺氧诱导因子1α和葡萄糖转运蛋白1在肺腺癌中的表达及其临床意义

Expression of hypoxia inducible factor 1αand glucose transporter 1 in lung adenocarcinoma and their clinical significances

目的 研究缺氧诱导因子1α（HIF-1α）、葡萄糖转运蛋白1（GLUT1）在肺腺癌中的表达及其与肿瘤转移的相关性.方法 应用免疫组织化学方法检测125例肺腺癌患者（未转移肺腺癌41例、淋巴结转移38例、脑转移46例）的GLUT1及HIF-1α的蛋白表达情况.采用χ^2检验和Pearson相关分析GLUT1及HIF-1α的表达及其相关性.结果 组织学上肺腺癌肿瘤组织异质性较大,多数肿瘤中均包含两种及以上不同的腺癌结构.未转移肺腺癌中以腺泡为主型腺癌多见（73.2%,30/41）;淋巴结转移肺腺癌中以腺泡为主型腺癌（53.6%,15/38）和实性为主型腺癌（26.3%,10/38）多见;脑转移肺腺癌中以乳头为主型腺癌（47.8%,22/46）和实性为主型腺癌（34.8%,16/46）多见.GLUT1及HIF-1α表达在淋巴结转移和脑转移肺腺癌组比未转移肺腺癌组明显增高（均P〈0.05）;GLUT1与HIF-1α的表达呈正相关（r=0.407,P=0.000）.结论 肺腺癌脑转移患者组织学上多为乳头型腺癌,提示乳头状腺癌更容易出现脑转移.HIF-1α及GLUT1的表达在肺腺癌淋巴结转移和脑转移中发挥重要作用.

Objective To investigate the expression of hypoxia inducible factor 1α （HIF-1α） and glucose transporter 1 （GLUT1） in lung adenocarcinoma and its correlation with tumor metastasis. Methods SP immunohistochemistry was used to detect GLUT1 and HIF-1α protein expression in 125 lung adenocarcinoma, including 41 cases without metastasis, 38 cases with lymphatic metastasis and 46 cases with brain metastasis. The correlation of GLUT1 and HIF-1α in lung adenocarcinoma metastasis was analyzed by using x 2 test and Pearson correlation analysis. Results Most lung adenocarcinoma were histologically heterogeneous, which contained more than one adenocarcinoma type. 73.2 % （30/41） cases were acinar predominant adenocarcinoma in lung adenocarcinoma without metastasis; 53.6 % （15/38） cases were acinar predominant adenocarcinoma and 26.3 % （10/38） cases were solid predominant adenocarcinoma in lung adenocarcinoma with lymphatic metastasis; 47.8 % （22/46） cases were papillary predominant adenocarcinoma and 34.8 % （16/46） cases were solid predominant adenocarcinoma in lung adenocarcinoma with brain metastases. The expression level of GLUT1 and HIF-1α in lung adenocarcinoma with lymphatic metastasis group was higher than that of the group without tumor metastasis （P〈 0.05）; the expression of GLUT1 and HIF-1α were positively correlated （r=0.407, P=0.000）. Conclusions Papillary adenocarcinoma is the most histological type in lung adenocarcinoma with brain metastasis, suggesting that papillary adenocarcinoma is more prone to brain metastasis. The expression of GLUT1 and HIF-1α play an important role in lymph node metastasis and brain metastasis of lung adenocarcinoma.