国际肿瘤学杂志

国际肿瘤学杂志 ›› 2018, Vol. 45 ›› Issue (8): 478-482.doi: 10.3760/cma.j.issn.1673422X.2018.08.006

• 论著 • 上一篇    下一篇

缺氧诱导因子1α蛋白的表达与胃癌患者临床病理特征及预后的关系

黄春珍,李建旺,元建华,毛山山,陈琼慧,张玮芳   

  1. 570208 海南省海口市人民医院（中南大学湘雅医学院附属海口医院）
  • 出版日期:2018-08-08 发布日期:2018-11-01
  • 通讯作者: 李建旺，Email: ljw7505@163.com E-mail:ljw7505@163.com

Relationships between expression of hypoxiainducible factor1α protein and clinicopathological characteristics and prognosis of patients with gastric cancer

Huang Chunzhen, Li Jianwang, Yuan Jianhua, Mao Shanshan, Chen Qionghui, Zhang Weifang   

  1. Department of Oncology, Haikou People′s Hospital of Hainan Province (Affiliated Haikou Hospital of Xiangya School of Medicine of Central South University), Haikou 570208, China
  • Online:2018-08-08 Published:2018-11-01
  • Contact: Li Jianwang E-mail:ljw7505@163.com
  • Supported by:

    Medical Scientific Research Foundation of Hainan Province of China (14A210246)

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摘要： 目的探讨缺氧诱导因子1α（HIF1α）蛋白在胃癌中的表达情况及其与胃癌患者临床病理特征和预后的关系。方法选取2011年3月3日至2012年9月28日我院病理科制作的胃腺癌患者癌组织芯片49例，配对癌旁组织49例，采用免疫组织化学法检测49例胃腺癌及配对癌旁组织芯片中HIF1α的表达。采用KaplanMeier评估无进展生存期（PFS）和总生存期（OS），采用Cox比例风险模型分析HIF1α是否为预后影响因素。结果HIF1α蛋白在胃癌组织中的高表达率明显高于癌旁组织（42.9%∶4.1%），差异有统计学意义（χ2=20.509，P＜0.001）。HIF1α蛋白表达与患者TNM分期（χ2=4.601，P=0.032）、血管侵犯（χ2=6.766，P=0.009）和肿瘤分化（χ2=7.969，P=0.005）相关。HIF1α高表达患者比HIF1α低表达患者的中位PFS（16.2个月∶27.3个月）和中位OS（34.8个月∶43.8个月）明显缩短，差异均有统计学意义（中位PFS:χ2=4.661，P=0.002；中位OS:χ2=6.903，P=0.009）。单因素分析显示，HIF1α高表达与患者PFS和OS相关（PFS:HR=4.461, 95%CI为1.969~10.802, P＜0.001; OS: HR=3.109, 95%CI为1.274~7.588,P=0.013）；Cox多因素分析结果显示，HIF1α高表达是影响胃癌患者生存预后的独立危险因素（PFS：HR=4.747，95%CI为2.175～10.230，P＜0.001；OS：HR=3.171，95%CI为1.358～7.404，P=0.008）。结论HIF1α蛋白在胃癌组织中的高表达率明显高于癌旁组织，其表达与胃癌患者TNM分期、血管侵犯、肿瘤分化相关。HIF1α高表达与较短的中位OS和PFS相关，HIF1α高表达是胃癌患者生存预后的独立危险因素，有望成为预后不良的独立性标志物。

关键词: 胃肿瘤, 缺氧诱导因子1, 病理学, 临床, 预后

Abstract: ObjectiveTo investigate the expression level of hypoxiainducible factor1α (HIF1α) in gastric cancer and its relationship with clinicopathological characteristics and prognosis of patients with gastric cancer. MethodsFrom March 3, 2011 to September 28, 2012, 49 patients with gastric adenocarcinoma tissue chips were selected from pathology department of our hospital. They were matched with paracancerous tissues. The expression levels of HIF1α were measured by immunohistochemistry method in gastric cancer tissues and paracancerous tissues chips. KaplanMeier was used to evaluate the progressionfree survival (PFS) and overall survival (OS), and the Cox proportional hazards model was used to analyze whether HIF1α was a prognostic factor. ResultsThe high expression rate of HIF1α protein in gastric cancer was significantly higher than that in paired paracarcinoma group (42.9% vs. 4.1%, χ2=20.509, P<0.001). The expression of HIF1α protein was related to TNM stage (χ2=4.601, P=0.032), vascular invasion (χ2=6.766, P=0.009) and degree of differentiation (χ2=7.969, P=0.005). Compared with patients with low expression of HIF1α, the median PFS (16.2 months vs. 27.3 months) and median OS (34.8 months vs. 43.8 months) were shorter in the patients with high expression of HIF1α, and the differences were statistically significant (median PFS: χ2=4.661, P=0.002; median OS: χ2=6.903, P=0.009). The results of single factor analysis showed that overexpression of HIF1α was correlated with PFS and OS (PFS: HR=4.461, 95%CI: 1.96910.802, P＜0.001; OS: HR=3.109, 95%CI: 1.2747.588,P=0.013).  The results of Cox multivariate analysis showed that overexpression of HIF1α was the independent risk factor that affected the survival and prognosis of patients with gastric cancer (PFS: HR=4.747, 95%CI: 2.17510.230, P＜0.001; OS: HR=3.171, 95%CI: 1.3587.404, P=0.008). ConclusionThe high expression rate of HIF1α protein in gastric cancer tissues is significantly higher than that in paracancerous tissues. The expression of HIF1α is associated with TNM stage, vascular invasion, degree of differentiation in patients with gastric cancer. The high expression of HIF1α is associated with the shorter median OS and PFS. The high expression of HIF1α is an independent risk factor for the survival and prognosis of patients with gastric cancer, which is expected to be an independent marker of poor prognosis.

Key words: Stomach neoplasms, Hypoxiainducible factor 1, Pathology, clinical, Prognosis