低氧诱导因子1α和M2型丙酮酸激酶在幽门螺杆菌感染胃癌组织中的表达及其意义

The expression and significance of hypoxia-inducible factors-1α and pyruvate kinase type M2 in gastric carcinoma patients with Hp infection

目的探讨低氧诱导因子（hypoxia—inducible factors-1α，HIF-1α）和M2型丙酮酸激酶（pyruvate kinase type M2，PKM2）在幽门螺杆菌（Hp）感染胃组织癌变发展过程中的作用。方法应用实时荧光定量PCR和免疫组织化学方法检测85例胃癌组织中HIF-1α和PKM2mRNA表达．分析Hp（＋）胃癌组织中CagA基因表达。结果随着肿瘤分化程度的降低、浸润深度和肿瘤临床分期的增加，HIF-1α和PKM2的阳性表达率均增高，并且二者表达水平呈正相关（r=0．783，P〈0．01）。HIF-1α的阳性表达（73％）与淋巴结转移呈正相关（χ2=4．204，P=0．041），PKM2的阳性表达（85％）与肿瘤直径呈正相关。HIF-1α和PKM2在跏感染的胃癌组织中的表达水平（75％和85％）均高于对照组（χ2=6．486，P=0．010；χ2=7．341，P=0．009），并且在CagA＋者中，二者的表达阳性率（83％和92％）的升高更为显著。结论HIF-1α和PKM2介导的通路可能在肋感染胃组织癌变过程中发挥重要作用。

Objective To study the expression of hypoxia-inducible factors-1α and pyruvate kinase type M2 in Hp infected gastric carcinoma and their clinical significances. Methods The expression levels of hypoxia-inducible factors-1α and pyruvate kinase type M2 in 85 cases of gastric carcinoma tissues were detected by using RT-PCR and immunohistochemical method. The Virulence level of CagA gene were detected in Hp infected gastric tissue. Results As the degree of tumor differentiation, invasion depth and clinical stage of tumor increased, the positive expression rate of HIF-1α and PKM2 increased, and the expression level of the two was in positive correlation. The positive expression rate of HIF-1α （73%）was related to lymph node metastasis （χ2 = 4. 204, P = 0. 041 ）. The positive expression rate of PKM2 （85 % ）was related to tumor diameter. The positive expression rate of HIF-1α and PKM2 （75% and 85% , respectively） significantly increased in Hp infected gastric carcinoma tissue （χ2 = 6. 486, P = 0. 010 ; χ2 = 7. 341, P = 0. 009, respectively ） and related to CagA ＋ type. Conclusion HIF-1α and PKM2 may be closely correlated to development and metastasis of gastric carcinoma with Hp infection.