乏氧诱导因子-1α在不可手术宫颈癌中表达水平与放化疗效果的相关性研究

Study on the Correlation between the Expression Level of Hypoxia-inducible Factor-1α in Inoperable Cervical Cancer and Curative Effect of Radiotherapy and Chemotherapy

目的:探究乏氧诱导因子-1α(HIF-1α)的表达水平与不可手术宫颈癌患者放化疗后短期、长期预后的关联性。方法:选取本院2012年6月-2015年6月收治的不可手术并接受放化疗综合治疗措施的宫颈癌患者134例,通过特异性HIF-1α抗体检测癌组织内HIF-1α的表达情况,将其分为HIF-1α表达(-)组和HIF-1α表达(+)组,两组患者均于放化疗后4周予以短期疗效评判;然后随访2年,统计患者局部控制率与生存率,分析评估HIF-1α的表达水平对放化疗后短期及长期预后的影响。结果:134例的不可手术的宫颈癌患者中,HIF-1α表达(-)者共35例(26.1%),包括Ⅱ期19例、Ⅲ期12例、IVa期4例;HIF-1α表达(+)者共99例(73.9%),包括Ⅱ期47例、Ⅲ期37例、IVa期15例。短期疗效分析显示:HIF-1α表达(-)组肿瘤治疗有效率为91.4%(32/35),明显高于HIF-1α表达(+)组的79.8%(79/99)(x^2=7.24,P<0.05)。长期疗效分析:HIF-1α表达(-)组2年局控率为88.6%(31/35)高于HIF-1α表达(+)组的75.8%(75/99)(x^2=4.892,P<0.05);HIF-1α表达(-)组2年生存率为94.3%,明显高于HIF-1α表达(+)组的78.8%(x^2=6.134,P<0.05)。结论:HIF-1α的表达水平与不可手术宫颈癌放化疗短期、长期疗效之间存在关联性;HIF-1α表达(-)的患者接受放化疗后,短期有效率、2年局控率、2年生存率均高于HIF-1α表达(+)的患者;因此HIF-1α可考虑作为不可手术宫颈癌患者疗效预测的生物标志物之一。

Objective：To investigate the relationship between the expression level of hypoxia inducible factor-1α（HIF-1α） and short-term and long-term prognosis of patients with inoperable cervical cancer after radiochemotherapy.Method：A total of 134 patients with cervical cancer who were treated with radiotherapy and chemotherapy were enrolled in our hospital from June 2012 to June 2015.The expression of HIF-1α in cancer tissues was detected by specific HIF-1α antibody,the patients were divided into two groups：HIF-1α（-） group and HIF-1α（＋） group.Both groups were evaluated short-term after 4 weeks of radiotherapy and chemotherapy.Then,the local control rate and survival rate were analyzed,and the effect of HIF-1α expression on the shortterm and long-term prognosis after radiotherapy and chemotherapy was analyzed and evaluated.Result：Totally 35 cases（26.1%） had HIF-1α expression（-） in 134 cases of unresectable cervical cancer,including 19 cases of stage Ⅱ,12 cases of stage Ⅲ and 4 cases of stage Iva.The expression of HIF-1α expression（＋）99 cases（73.9%）,including 47 cases of stage Ⅱ,37 cases of stage Ⅲ and 15 cases of stage Iva.Short-term curative effect analysis showed that the effective rate of tumor treatment in the HIF-1 α expression（-） group was 91.4%（32/35）,which was significantly higher than 79.8%（79/99） in the HIF-1α expression（＋）group（ x^2=7.24,P0.05）.Long-term therapeutic analysis：the 2-year local control rate was 88.61%（31/35）in the HIF-1α expression（-） group,which was higher than 79.8%（75/99） in the HIF-1α expression（＋）group（ x^2=4.892,P0.05）;the 2-year survival rate of HIF-1α expression（-） group was 94.3%,which was significantly higher than 78.8% of HIF-1 α expression（＋） group（ x^2=6.134,P0.05）.Conclusion：There is a correlation between the expression level of HIF-1α and the short-term and long-term curative effect of radiotherapy and chemotherapy for inoperable cervical cancer.Short-term effective rate,2-year local control rate,2-year survival rates were higher than those with HIF-1α expression（＋）;therefore,HIF-1α could be considered as one of the biomarkers for predicting the efficacy of inoperable cervical cancer.