胃癌组织中缺氧诱导因子-1α和环氧合酶-2的表达及其与淋巴结转移和血管生成的关系

目的研究胃癌组织中缺氧诱导因子-1（HIF-1）和环氧合酶-2（COX-2）表达的临床病理学意义,探讨其与淋巴结转移、微血管密度（MVD）的关系。方法采用免疫组织化学法检测64例胃癌和15例正常胃黏膜组织中HIF-1α和COX-2的表达,用CD34抗体标记微血管并计数相应的微血管密度（MVD）。结果64例胃癌组织中HIF-1α和COX-2的阳性表达率分别为67．19％和78．13％,HIF-1α与COX-2在胃癌组织中的表达水平明显高于正常胃组织中的表达水平（P〈0．05）。HIF-1α和COX-2的表达与胃癌的临床TNM分期、浸润深度和淋巴结转移有关（P〈0．05）;与患者的年龄、性别和组织学分级无关。HIF-1α和COX-2之间存在显著相关性（L=0．584,P〈0．01）。HIF-1俚阳性表达组的MVD均值（36．78±10．46）明显高于阴性表达组（17．92±3．71）,COX-2阳性表达组的MVD均值（37．59±10．75）明显高于阴性表达组（18．43±4．15）,HIF-1α、COX-2的表达与MVD之间呈正相关（t=0．624,P〈0．01,0．697,P〈0．01）。结论HIF-1α和COX-2在胃癌的发生、发展中起重要作用,并且在促进肿瘤血管形成过程中两者可能起协同作用,联合检测可作为判断胃癌恶性程度和预后的指标。     

Hypoxia-inducible factor-1alpha expression and angiogenesis in gastrointestinal stromal tumor of the stomach

Hypoxia inducible factor (HIF)-1 is reported to transactivate expression of vascular endothelial growth factor (VEGF), which is an important angiogenic factor. The aim of this study was to elucidate the clinical significance of HIF-1alpha expression in gastrointestinal stromal tumors (GIST). Specimens obtained from 53 patients who underwent surgical resection for GIST of the stomach were used in this study. Specimens were examined immunohistochemically for HIF-1alpha, VEGF, and Ki-67 expression. Tumor microvessel density (MVD) was determined immunohistochemically with anti-CD31 antibody and was estimated by averaging the counts from three high-power fields in the area showing the greatest neovascularization. HIF-1alpha expression was detected in 17 (32.1%) of 53 lesions and was correlated significantly with tumor size, liver metastasis, VEGF expression, and MVD. Prognosis was significantly poorer in patients with tumors expressing HIF-1alpha than in patients with tumors lacking HIF-1alpha expression. HIF-1alpha may play a role in angiogenesis and tumor progression of GIST through regulation of VEGF.     

High-grade clear cell renal cell carcinoma has a higher angiogenic activity than low-grade renal cell carcinoma based on histomorphological quantification and qRT-PCR mRNA expression profile

Clear cell renal cell carcinoma (CC-RCC) is a highly vascularised tumour and is therefore an attractive disease to study angiogenesis and to test novel angiogenesis inhibitors in early clinical development. Endothelial cell proliferation plays a pivotal role in the process of angiogenesis. The aim of this study was to compare angiogenesis parameters in low nuclear grade (n=87) vs high nuclear grade CC-RCC (n=63). A panel of antibodies was used for immunohistochemistry: CD34/Ki-67, carbonic anhydrase IX, hypoxia-inducible factor-1alpha (HIF-1alpha) and vascular endothelial growth factor (VEGF). Vessel density (MVD - microvessel density), endothelial cell proliferation fraction (ECP%) and tumour cell proliferation fraction (TCP%) were assessed. mRNA expression levels of angiogenesis stimulators and inhibitors were determined by quantitative RT-PCR. High-grade CC-RCC showed a higher ECP% (P=0.049), a higher TCP% (P=0.009), a higher VEGF protein expression (P<0.001), a lower MVD (P< 0.001) and a lower HIF-1alpha protein expression (P=0.002) than low-grade CC-RCC. Growth factor mRNA expression analyses revealed a higher expression of angiopoietin 2 in low-grade CC-RCC. Microvessel density and ECP% were inversely correlated (Rho=-0.26, P=0.001). Because of the imperfect association of nuclear grade and ECP% or MVD, CC-RCC was also grouped based on low/high MVD and ECP%. This analysis revealed a higher expression of vessel maturation and stabilisation factors (placental growth factor, PDGFB1, angiopoietin 1) in CC-RCC with high MVD, a group of CC-RCC highly enriched in low nuclear grade CC-RCC, with low ECP%. Our results suggest heterogeneity in angiogenic activity and vessel maturation of CC-RCC, to a large extent linked to nuclear grade, and, with probable therapeutic implications.     

UP－REGULATION OF CYCLOOXYGENASE－2 GENE EXPRESSION CORRELATES WITH TUMOR ANGIOGENESIS IN HUMAN BREAST CANCER

Prostaglandins(PGs) play a critical role in tumor development and growth by regulating numerous biologic processes, including tumor angiogenesis[1]. Cyclooxygenase-2 (COX-2) is an inducible enzyme that converts arachidonic acid to PGs. Overexpression of the COX-2 gene in mammary glands of transgenic mice was sufficient to induce tumorigenesis[2]. COX-2expression may contribute to the synthesis of PGs, which have been related to carcinogenesis and tumor progression. Recent studies have sh…     

COX-2和HIF-1α在肝细胞癌中的表达及意义

目的：研究环氧化酶-2（COX-2）和缺氧诱导因子-1α（HIF-1α）在肝细胞癌（HCC）中的表达及意义。方法：采用原位杂交技术检测48例HCC组织中COX-2mRNA和HIF-1αmRNA的表达，通过免疫组化sP法，用抗CD34抗体标记血管内皮细胞，检测微血管密度（MVD）。结果：COX-2mRNA在HCC中的表达显著高于正常肝组织（P〈0．05），并与肿瘤数目、血管侵袭、淋巴结转移、临床分期显著相关（P〈0．05）；HIF-1αmRNA在HCC中的表达亦显著高于正常肝组织（P〈0．05），并与肿瘤分化程度、包膜形成、血管侵袭、淋巴结转移、临床分期显著相关（P〈0．05）；COX-2mRNA、HIF-1αmRNA的表达均与MVD呈正相关（P〈0．05）；COX-2mRNA与HIF-1αmRNA的表达强度呈正相关（P〈0．05）。结论：COX-2和HIF-1α在HCC的发生、发展、浸润和转移中发挥重要作用，促进了血管生成，且两者具有协同效应。     

Clinicopathologic significance of hypoxia-inducible factor 1alpha overexpression in gastric carcinomas

BACKGROUND: Hypoxia-inducible factor 1alpha (HIF-1alpha) plays a key role in responses to hypoxia and expression of HIF-1alpha downstream genes leads to both an adapted metabolism and increased oxygen supply. We investigated the clinical significance of HIF-1alpha expression in gastric carcinoma. METHODS: We examined HIF-1alpha, vascular endothelial growth factor (VEGF), and insulin-like growth factor-2 (IGF-2) expression patterns immunohistochemically in 126 specimens of gastric carcinoma. CD34 antigen levels were also examined by immunohistochemistry to determine microvessel density (MVD) within tumors and correlations between HIF-1alpha expression, clinicopathological features, and survival were examined. RESULTS: HIF-1alpha expression correlated with tumor size (P<0.005), depth of invasion (P=0.018), VEGF expression (P=0.03), and intra-tumor MVD (P<0.005). IGF-2 expression was more prevalent in HIF-1alpha positive than in HIF-1alpha negative tumors and the 5-year survival rate was 58.4% for HIF-1alpha positive patients and 81.5% for HIF-1alpha negative patients (P=0.009). HIF-1alpha expression is an independent prognostic factor in gastric carcinoma (P=0.032). CONCLUSIONS: Overexpression of HIF-1alpha in gastric carcinomas may upregulate its downstream gene products leading to VEGF-mediated angiogenesis, and resulting in a poor prognosis for patients.     

环氧合酶-2 在子宫内膜癌中的表达及其与肿瘤血管形成的关系

 目的 探讨环氧合酶-2(Cyclooxygenase-2，COX2)在子宫内膜癌组织中表达及与肿瘤血管形成的关系。方法 采用免疫组化SIP方法检测34例子宫内膜癌组织COX-2和血管内皮生长因子(Vascu1arendothelial growth factor，VEGF)的表达和微血管密度(Microvessel density，MVD)，观察COX-2表达与肿瘤血管形成之间的相关性。结果 COX-2在子宫内膜癌组织中的阳性表达率为64．7％，而对照组正常子宫内膜均未见表达，内膜癌组的中分化细胞COX-2蛋白的表达高于低分化细胞，差异有显著性(P<0．05)；COX-2表达阳性组和阴性组MVD分别为(41．53±19．10和28．79±8．20)，两组比较具有显著性差异(P<0．05)。COX-2的表达评分与VEGF及MVD高度均呈正相关(P<0．01；P<0．0001)。结论 COX-2可能主要参与子宫内膜癌发生的早期；子宫内膜癌组织中COX-2的高表达可能在VEGF诱导肿瘤血管形成的过程中起重要作用。     

动态增强MRI对鼻咽癌组织内乏氧和血管生成检测的研究

目的探讨鼻咽癌MRI动态增强参数与微血管密度（MVD）和乏氧诱导因子-1α（HIF-1α）、血管内皮生长因子（VEGF）表达的相关性。方法①对14例鼻咽癌初诊患者,行MR动态增强扫描,获取该区域动态增强曲线,然后在标记处行鼻咽镜活检,测定活检部位的MVD和HIF-1α、VEGF表达水平;②观察动态增强曲线特征,测量并计算ROI的MRI动态增强参数。结果活检部位slope、MS、SImax与VEGF表达呈正相关关系（γ分别为0.889、0.882、0.619,P〈0.05）,与HIF-1α表达呈正相关关系（γ分别为0.870、0.825、0.665,P〈0.05）,与MVD也呈正相关关系（γ分别为0.627、0.755、0.693,P〈0.05）;T1 on set、TTP与VEGF表达呈负相关关系（γ分别为-0.909,-0.829,P〈0.05）,与HIF-1α表达呈负相关关系（γ分别为-0.687,-0.690,P〈0.05）,与MVD也呈负相关关系（γ分别为-0.578,-0.852,P〈0.05）。结论鼻咽癌活检部位的MRI动态增强参数与MVD、HIF-1α、VEGF表达有统计学相关性;MR动态增强扫描结果为检测鼻咽癌肿瘤组织内乏氧与血管生成提供依据。     

Correlation between cyclooxygenase-2 and tumor angiogenesis in non-small cell lung cancer

The role of COX-2 expression and angiogenesis of lung cancer is yet to be delineated. Eighty four non-small cell lung cancer (NSCLC) specimens were evaluated for COX-2 expression, microvessel density (MVD), and vascular endothelial growth factor (VEGF) expression by immunohistochemical methods. The relationships between COX-2 expression and MVD, VEGF expression, and survival time were analyzed. COX-2 expression was observed in the cytoplasm and membrane of the carcinoma cells, and premalignant cells. COX-2 was positive in 67 cases (79.8%). There was a statistically significant correlation between COX-2 expression and tumor size, TNM stage, tumor type, VEGF expression, and vascular pattern with survival in univariate analysis. No significant correlation was seen between COX-2, VEGF expression and MVD. A lack of expression of either COX-2 or VEGF expression or both, however, was associated with lower MVD than the group with both expressed. The difference was statistically significant (P=0.005). Statistically significant differences were also observed according to TNM stage, vascular pattern, COX-2 expression, and VEGF expression. With multivariate analysis, only TNM stage and COX-2 expression retained their significance as independent predictors of survival. COX-2 expression takes part in tumor angiogenesis and is a significant poor prognostic factor in the surgically resected NSCLC. COX-2 inhibitor, either in combination therapy with other agents, or for chemoprevention, may be effective via suppression of angiogenesis in this fatal disease.     

Inhibition of heme oxygenase-1 by zinc protoporphyrin IX reduces tumor growth of LL/2 lung cancer in C57BL mice

Heme oxygenase (HO)-1 is a key player reducing cytotoxicity and enhancing protumoral effects of nitric oxide (NO). We examined zinc protoporphyrin (ZnPP) IX, an HO-1 inhibitor, to affect tumor growth of LL/2 mouse lung cancer cells. ZnPPIX reduced HO-1 expression and HO activity in LL/2 cells, whereas cobalt PPIX (CoPPIX), an HO-1 activator, increased both. LL/2 cells treated with sodium nitropurusside, an NO donor, showed growth inhibition dose-dependently, which was enhanced by ZnPPIX cotreatment, but was reduced by CoPPIX. In mice tumors, ZnPPIX decreased HO-1 expression. LL/2-tumors were found in 88% (7/8) vehicle-treated mice, whereas tumors were found in 38% (3/8) and 25% (2/8) mice treated with 5 and 20 microg/mouse ZnPPIX, respectively (p = 0.0302). Tumor growth was inhibited dose-dependently by ZnPPIX. Vascular endothealial growth factor concentration in tumors was reduced by ZnPPIX (p = 0.0341). Microvessel density (MVD) in ZnPPIX-treated tumors was lower than that in vehicle-treated tumors (p = 0.0362). Apoptotic cell count in ZnPPIX-treated tumors was higher than that in vehicle-treated tumors (p = 0.0003). In contrast, CoPPIX treatment increased HO-1 expression, enhanced tumorigenicity and MVD and reduced apoptosis. From these findings, inhibition of HO-1 by ZnPPIX provides relevant antitumoral effects.     

环氧化酶2和血管内皮生长因子在透明细胞性肾细胞癌中的表达及其与血管生成的关系

目的 探讨透明细胞性肾细胞癌(CCRCC)组织中环氧化酶2(COX-2)和血管内皮生长因子(VEGF)的表达及其与血管生成的关系.方法 应用免疫组化Envision法,检测80例CCRCC和20例正常.肾组织中COX-2和VEGF的表达及CD34标记的微血管密度(MVD),结合临床病理特征进行综合分析,探讨CCRCC组织中COX-2和VEGF的表达与血管生成的关系.结果 在CCRCC组织和正常肾组织中均有COX-2和VEGF表达.80例CCRCC中,COX-2和VEGF表达阳性率分别为65.0%和61.3%,均明显高于正常肾组织(分别为10.0%和20.0%).80例CCRCC组织MVD为70.13±19.99,20例止常肾组织MVD为59.75±15.17,差异有统计学意义(P＜0.05).COX-2的表达与CCRCC组织学分级、TNM分期及淋巴结转移有关(P＜0.05).CCRCC组织中,COX-2的表达与VEGF的表达呈正相关(r=0.485),COX-2和VEGF的表达均与MVD正相关(r分别为0.851和0.736).结论 COX-2与CCRCC血管生成有关,VEGF可能是COX-2调节CCRCC血管生成的重要中介.     

环氧化酶-2对鼻咽癌血管生成及预后的影响

Objective： The purpose of this study was to evaluate cyclooxygenase-2 （COX-2） expression in nasopharyngeal carcinoma （NPC） and its correlation with clinicopathologic features, angiogenesis, and prognosis. Methods： The expressions of COX-2 and vascular endothelial growth factor （VEGF） and microvascular density （MVD） were determined with immunohistochemical methods in eighty-six NPC patients followed up over 5 years. Results： Sixty-three tumors （73.3%） were classified as COX-2 positive. COX-2 expression was positively related to VEGF expression （r=0.438, P〈0.01） and correlated with the tumor pathological grade, extent of primary lesion, lymph node metastasis, distant metastasis and shorter survival. Conclusion： Our results suggest that COX-2, being highly expressed and strongly correlated with angiogenesis in nasopharyngeal carcinoma, is apt to be used as a predictor of prognosis, including local recurrence and distant metastasis.     

Correlation of Delta-like Ligand 4 (DLL4) with VEGF and HIF-1α Expression in Human Glioma

To investigate the potential role of the notch ligand delta-like ligand 4 (DLL4) in glioma angiogenesis, weexamined whether its expression correlates with that of vascular endothelial growth factor (VEGF) and hypoxiainducedfactor-1α (HIF-1α). Eighty-two specimens of human glioma and 7 of normal brain tissue were subjectedto immunohistochemical analysis for DLL4, VEGF and HIF-1α expression. Statistical analysis were performedto determine if protein expression correlated with clinicopathological parameters, including histological type,pathological grade, and microvessel density (MVD), determined using CD34-labelling. Expression of DLL4,VEGF and HIF-1α was very strong in gliomas, relative to normal tissues, linked with the malignant grade.Moreover, DLL4 staining positively correlated with VEGF and HIF-1α expression and with MVD. Thus ourresults indicate that DLL4 represents a potential biomarker and therapeutic target for glioma angiogenesis.     

Coexpression of hypoxia-inducible factors 1alpha and 2alpha, carbonic anhydrase IX, and vascular endothelial growth factor in nasopharyngeal carcinoma and relationship to survival.

PURPOSE: Tumor hypoxia is known to be associated with resistance to chemotherapy, radiotherapy, and poorer survival. Recently, it is shown that hypoxia induces the expression of hypoxia-inducible factor-1alpha and 2alpha (HIF-1alpha and HIF-2alpha), which then up-regulates the expression of downstream genes such as carbonic anhydrase IX (CA IX) and vascular endothelial growth factor (VEGF). EXPERIMENTAL DESIGN: We examined the expression of HIF-1alpha, HIF-2alpha, CA IX, and VEGF by immunohistochemistry in nasopharyngeal carcinoma (NPC) biopsies from 90 consecutive patients recruited between 1994 and 1997 in a randomized controlled trial of chemoradiation in locally advanced NPC and investigated their relationship with survival. RESULTS: HIF-1alpha was expressed in 52 of 90 (58%), HIF-2alpha in 6 of 89 (7%), CA IX in 51 of 90 (57%), and VEGF in 54 of 90 (60%) of tumors. Tumor HIF-1alpha expression correlated significantly with that of CA IX (P = 0.008) and VEGF (P = 0.003). High tumor HIF-1alpha expression was associated with a trend for poor overall survival (P = 0.06). Tumors with a positive hypoxic profile (defined as high expression of both HIF-1alpha and CA9) were associated with worse progression-free survival (P = 0.04). Tumors with both hypoxic and angiogenic profile (defined as high VEGF expression) were associated with a worse progression-free survival (P = 0.0095). CONCLUSION: Overexpression of HIF-1alpha, CA IX, and VEGF is common in NPC, which is probably related to hypoxia up-regulated expression involving a HIF-dependent pathway, and is associated with poor prognosis. Targeting the hypoxia pathway may be useful in the treatment of NPC.     

卵巢交界性肿瘤血管内皮生长因子表达和微血管密度的研究

背景与目的:血管生成是实体肿瘤生长、侵袭、扩散转移的关键,微血管密度(microvesselofdensity,MVD)可反映肿瘤的血管形成情况。血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)是具有重要意义的促血管生长因子,它与肿瘤的生长密切相关。本研究检测卵巢交界性肿瘤组织中VEGF的表达和MVD,探讨它们与临床病理特征及预后的关系。方法:采用免疫组化SP法和原位杂交技术检测69例卵巢交界性肿瘤、18例卵巢良性肿瘤和27例卵巢恶性肿瘤组织中VEGF蛋白及VEGFmRNA的表达,用FⅧ因子单克隆抗体标记新生血管内皮,计数并计算MVD。结果:VEGF蛋白、VEGFmRNA在卵巢交界性肿瘤组织中的表达均介于卵巢良性肿瘤与卵巢恶性肿瘤之间,其结果差异均有显著性(P<0.05);也与卵巢交界性肿瘤的临床分期、MVD值密切相关(P<0.05);但VEGF与卵巢交界性肿瘤的组织分型、有无腹腔种植无关(P>0.05)。结论:VEGF与卵巢肿瘤的生长、侵袭、转移密切相关;检测VEGF有助于判断卵巢肿瘤的恶性程度,为判断卵巢交界性肿瘤患者的预后提供依据。     

Elevated Expression of Thymosin β4, Vascular Endothelial Growth Factor (VEGF), and Hypoxia Inducible Factor (HIF)-1α in Early-Stage Cervical Cancers

Recent studies have shown that thymosin β4 (TB-4) is highly related with tumor metastasis and angiogenesis. In addition, TB-4 induced the expression of VEGF in melanoma cells. We investigated the expression patterns of TB-4 and related angiogenic proteins, VEGF, and HIF-1α, at various stages of cervical cancers and also identified the expression pattern of these proteins in metastatic cervical cancers. Expression patterns of TB-4, VEGF, and HIF-1α were studied with tissue microarray containing 42 samples of cervical cancers. In addition, 15 cervical cancers and metastatic tumors in lymph nodes from patients who have metastatic tumors were also analyzed to confirm the role of TB-4, VEGF, and HIF -1α in cervical cancer metastasis. The expression levels of TB-4, VEGF, and HIF-1α were very weak at early cancer stages (stages 0 to 1A) but significantly increased at stage 1B. The numbers of blood vessels in tumors were also increased at stage 1B. The expression patterns of TB-4, VEGF, and HIF-1α were compared in tumors without lymph node metastasis, primary tumors with lymph node metastasis, and metastatic tumors in lymph nodes. The expression levels of TB-4, VEGF, and HIF-1α in primary tumors with lymph node metastasis and their metastatic tumors in lymph node were less than in tumors without lymph node metastasis. These data suggest that TB-4, VEGF, and HIF-1α triggered angiogensis and tumor invasiveness to surrounding tissues at early stage of cervical carcinoma but have a negative or no effect on the metastatic potential.