小儿肾母细胞瘤中HIF-1α和Ki67的表达及与临床病理特征和预后的关系

Expression of HIF-1αand Ki67 in children′s Wilms′tumor and its relationship with clinicopathological characteristics and prognosis

目的检测肾母细胞瘤(WT)患儿的病理组织中缺氧诱导因子-1α(HIF-1α)和细胞核相关抗原(Ki67)的表达,分析其与患儿临床病理特征和预后的关系。方法收集2015年3月至2017年3月在本院收治的52例WT患儿的癌组织和相应的癌旁组织标本,采用免疫组化法检测癌组织和癌旁组织中HIF-1α、Ki67的表达。采用单因素和多因素logistic回归模型分析WT患儿癌组织中HIF-1α、Ki67表达与其临床病理特征的关系。Kaplan-Meier生存曲线分析WT患儿癌组织中HIF-1α、Ki67表达与其预后生存期的关系。结果WT患儿癌组织中的HIF-1α表达阳性率高于癌旁组织[88.46%(46/52)vs.40.38%(21/52)],Ki67表达阳性率高于癌旁组织[80.77%(42/52)vs.46.15%(24/52)],差异均有统计学意义(均P<0.05)。WT患儿癌组织中HIF-1α阳性细胞数量高于癌旁组织[(69.84±9.53)个vs.(1.15±0.93)个],Ki67阳性细胞数量高于癌旁组织[(72.46±10.41)个vs.(1.04±0.85)个],差异均有统计学意义(均P<0.05)。HIF-1α阳性表达是WT患儿的肿瘤分期、淋巴结转移的独立影响因素(均P<0.05)。Ki67阳性表达是WT患儿的病理类型、肿瘤分期、淋巴结转移的独立影响因素(均P<0.05)。HIF-1α高表达患儿的中位生存时间低于HIF-1α低表达患儿(38个月vs.49个月)。Ki67高表达患儿的中位生存时间低于Ki67低表达患儿(40个月vs.53个月)(均P<0.05)。结论WT患儿病理组织中存在HIF-1α、Ki67的高表达。HIF-1α阳性表达与WT患儿的肿瘤分期、淋巴结转移存在独立的影响关系。Ki67的阳性表达与WT患儿的病理类型、肿瘤分期、淋巴结转移存在独立影响关系。HIF-1α、Ki67低表达患儿的预后生存期较长。

Objective To detect the expression of hypoxia inducible factor-1α(HIF-1α)and nuclear related antigen(Ki67)in the pathological tissues of children with Wilms′tumor(WT),and to analyze the relationship with the WT characteristics and prognosis of the children.Methods Cancer tissue and corresponding paracancer tissue samples were collected from 52 WT children admitted to our hospital from March 2015 to March 2017.The expressions of HIF-1αand Ki67 in cancer tissue and paracancer tissue were detected by immunohistochemical method.Univariate analysis and multiple logistic regression models were used to analyze the relationship between HIF-1αand Ki67 expression and clinicopathological characteristics in WT children.Kaplan-Meier survival curve analysis of the relation-ship between the expression of HIF-1αand Ki67 in WT children and their prognostic survival.Results The positive rate of HIF-1αexpression in WT children was higher than that in adjacent tissues[88.46%(46/52)vs.40.38%(21/52)].The positive rate of Ki67 expression was higher than that of paracancer tissues[80.77%(42/52)vs.46.15%(24/52)],and the differences were statistically significant(all P<0.05).The number of HIF-1αpositive cells in WT children's cancer tissue was higher than that in para-cancer tissue[(69.84±9.53)vs.(1.15±0.93)],and the number of Ki67 positive cells was higher than that in para-cancer normal tissue[(72.46±10.41)vs.(1.04±0.85)].The differences were statistically significant(all P<0.05).HIF-1αpositive expression was an independent factor for tumor stage and lymph node metastasis in WT children(all P<0.05).Ki67 positive expression was an independent factor for pathological type,tumor stage and lymph node metastasis in WT children(all P<0.05).The median survival time of children with high HIF-1αexpression was lower than that of the group with low HIF-1αexpression(38 months vs.49 months).The median survival time of children with high Ki67 expression was lower than that of children with low Ki67 expression(40 months vs.53 months),and the differences were statistically significant(all P<0.05).Conclusions There is high expression of HIF-1αand Ki67 in WT.The positive expression of HIF-1αhas an independent influence on the tumor stage and lymph node metastasis in children with WT.The positive expression of Ki67 has an independent influence on the pathological type,tumor stage and lymph node metastasis in children with WT.Children with low expression of HIF-1αand Ki67 have a longer prognostic survival.