缺氧诱导因子蛋白表达对食管癌术后辅助治疗的临床意义

 目的　探讨缺氧诱导因子（HIF-1α）蛋白表达在食管癌术后放疗中的意义。方法　回顾性研究1995年3月至1998 年2月间95 例有临床随访资料的食管癌术后患者，其中45例根治术后行辅助放疗，50例单纯手术的患者作对照，应用免疫组织化学方法检测食管癌石蜡切片中HIF-1α 蛋白的表达情况，应用Kaplan-Meier法和多变量COX比例风险模型进行生存及预后分析。结果　HIF-1α在食管癌组织中阳性表达主要位于肿瘤细胞核内，其HIF-1α蛋白表达阳性率为58.9%；HIF-1α蛋白表达与患者性别、年龄、病理类型、T分期之间无明显相关性（P＞0.05），但与复发及远处转移呈正相关（P＜0.05）；在单纯手术组和术后放疗组中HIF-1α蛋白阳性者和阴性者生存率差异有统计学意义（P＜0.05）；COX多因素分析结果显示HIF-1α是术后预后不良的独立因素。结论　HIF-1α蛋白阳性表达是食管癌患者预后较差的指标之一，HIF-1α蛋白表达阳性者较阴性者对放疗敏感性差。

Clinical significance of hypoxia inducible factor-1α expression on postoperative adjuvant radiotherapy in esophageal carcinoma

Objective To determine the effects of hypoxia inducible factor-1α(HIF-1α) expression on postoperative adjuvant radiotherapy in esophageal carcinoma. Methods 95 cases with esophageal carcinoms who received radical operation were analyzed with followed-up data from 1995 to 1998.Expression of HIF-1α in 45 patients with esophageal carcinoma who received radiotherapy after radical operation were deternlined by immunohistochemical method in contrast with 50 patients with esophageal carcinoma received surgery alone.Kaplan-Meier method and COX proportional hazard model were used to analyze.Results The positive expression of HIF-1α in esophageal carcinoma was observed mainly in the nucleus of tumor cells.The positive expression rate of HIF-1α in esophageal carcinoma was 58.9%.The expression of HIF-1α had no relationship with age,sex,histologic subtype and T stage,but had positive relationship with recurrence and distant metastasis.There was significant difference between patients with positive and negative HIF-1α protein expression in surgery alone and postoperation radiotherapy group. COX model analysis showed that HIF-1α had separate and significant impacts on prognosis in surgery group and surgery plus radiotherapy group. Conclusion Over expression of HIF-1α protein suggests a poor prognosis,and has tendency to resist radiotherapy in esophageal carcinoma.