缺氧诱导因子-1α和血管生成拟态在宫颈癌中表达的变化及其意义

Expression of hypoxia inducible factor-lα and vasculogenic mimicry in cervical cancer and its clinical significance

目的探讨缺氧诱导因子-lα(HIF-lα)和血管生成拟态(VM)在宫颈癌中的表达及其临床意义。方法收集2016年1~12月深圳市妇幼保健院收治的宫颈癌患者,其中宫颈上皮内瘤变(CIN)20例,宫颈鳞癌Ⅰ期20例(Ⅰ期组),宫颈鳞癌Ⅱ期15例(Ⅱ期组),正常宫颈组织16例作为对照组,免疫组化法检测各组宫颈组织中HIF-lα和VM的表达,分析HIF-lα和VM在不同期别和临床病理特征宫颈癌中的表达。结果 HIF-lα和VM在对照组、CIN组、Ⅰ期组和Ⅱ期组宫颈组织中表达阳性率逐渐升高,分别为0、5.0%、30.0%、73.3%和0、15.0%、45.0%、80.0%,组间比较差异均具有统计学意义(P<0.05);癌栓阳性和肿瘤直径>4 cm患者的HIF-lα阳性率分别69.20%和76.9%,明显高于癌栓阴性和肿瘤直径<4 cm患者(分别为27.3%和31.8%),差异均具有统计学意义(P<0.05);癌栓阳性和肿瘤直径>4 cm患者VM的阳性率分别83.3%和53.8%,明显高于癌栓阴性和肿瘤直径<4 cm患者(分别为24.1%和18.2%),差异均具有统计学意义(P<0.05);淋巴结阳性和癌细胞中低分化患者的HIF-lα和VM表达均高于淋巴结阴性和癌细胞高分化患者,但其差异无统计学意义(P>0.05)。结论 HIF-lα和VM表达随宫颈癌分期逐渐升高,并与癌栓阳性和肿瘤直径>4 cm相关,检测HIF-lα和VM对提高宫颈癌的诊治具有重要的临床意义。

Objective To investigate the expression of hypoxia inducible factor-lα（HIF-lα） and vasculogenic mimicry（VM） in the tumorgenesis of cervical cancer and its clinical significance.Methods The expression levels of HIF-lα and VM were examined by immunohistochemistry in different degree of cervical cancer and its percurcor from January 2016 to December 2016 in Shenzhen Maternal and Child Healthcare Hospital,including 20 cervical intraepithelial neoplasia（CIN）,20 cervical cancer phase Ⅰ,15 cervical cancer phase Ⅱ,and 16 normal cervical tissues as control.Then its relationship with different grade and clinicopathologic features of cervical cancer was analyzed.Results The positive expression rate of HIF-lα and VM were increased along with the degree of cervical cancer,which were 0,5.0%,30.0%,73.3% and 0,15.0%,45.0%,80.0%,respectively,and the differences had statistical significance（P〈0.05）.The positive expression rate of HIF-lα in patients with vascular cancer embolus and tumor diameter4 cm were 69.20% and 76.9%,which were higher than the corresponding 27.3% and 31.8% in the patients without cancer embolus and with tumor diameter 4 cm（P〈0.05）.The positive expression rate of VM in patients with vascular cancer embolus and tumor diameter4 cm were 83.3% and 53.8%,which were also significantly higher than the corresponding 24.1% and 18.2% in the patients without cancer embolus and with tumor diameter4 cm（P〈0.05）.The expressions of HIF-lα and VM in patients with lymphatic metastasis and moderate or poor differentiation were higher than those in the patients without lymphatic metastasis and with high differentiation,but the difference had no significance（P〉0.05）.Conclusion The expression of HIF-lα and VM increase with the degree of cancer and had relation with the clinicopathologic features of cervical cancer such as cancer embolus and tumor diameter4 cm,which had significance for the diagnosis and treatment of cervical cancer.