HIF—1α、2α和Survivin蛋白在食管鳞癌中的表达及临床意义

目的探讨缺氧诱导因子（HIF-1α、HIF-2α）和生存素蛋白（survivin）在食管正常粘膜、食管炎、食管鳞癌（ESCC）组织中的表达，并测定食管正常粘膜、食管炎、食管鳞癌组织中的微血管密度，初步分析它们与食管鳞癌生物学行为之间的关系。方法采用免疫组织化学（SP）方法分别检测65例食管正常粘膜、食管炎、食管鳞癌组织中HIF-1α、HIF-2α和survivin的表达，同时测定微血管密度（MVD）计数。结果（1）HIF-1α、HIF-2α和survivin在食管正常粘膜组织中不表达，食管炎组织中低表达，食管鳞癌中高表达，在食管不同组织分型中三者的表达比较具有显著性差异（P〈0．01）。随正常粘膜-炎症-癌的次序MVD计数呈逐渐升高趋势。（2）Survivin在食管鳞癌组织中表达越强，组织分化程度越低（P〈0．01）、TNM分期越晚（P〈0．01）、淋巴结转移率越高（P〈0．01）；HIF-1α和HIF-2α在食管鳞癌组织中表达越强，淋巴结转移率越高（P〈0．01），组织分化程度越低（P〈0．05），两者与组织分化程度、TNM分期呈负相关。（3）食管鳞癌中HIF-1α、HIF-2α表达与survivin表达呈正相关（P〈0．01），三者表达与MVD呈正相关（P〈0．01）。结论（1）HIF-1α、HIF-2α和survivin表达对食管鳞癌的发生、发展起正性协同作用；（2）检测食管鳞癌组织中survivin的表达对判断肿瘤的发生、发展具有重要意义。survivin可望成为诊断和治疗食管鳞癌的新靶点。

EXPRESSION OF HIF-1α、HIF-2α AND SURVIVIN IN ESOPHAGEAL SQUAMOUS CELL CANCER AND THEIR CLINICAL SIGNIFICANCES

Objective To identify MVD and illustrate survivin in normal mucosa of esophagitis and esophageal the significance of expression of HIF -1α,HIF -2α squamous cell cancer, and its relationship to the biological behavior of esophageal squamous cell cancer. Methods HIF -1α, HIF -2α and survivin in 65 specimens resection from patients with IHC S -P staining method normal mucosa,esophagitis and esophageal and identify the MVD as well. Results （1） squamous cell cancer were investigated by The expression of HIF -1α,HIF - 2α and survivin in normal mucosa was non - expression, low in esophagitis , high in esophageal squamous cell cancer , the expression of esophageal squamous cell cancer was significantly higher than its expression in normal mueosa and esophagitis（P 〈 0.01 ）. MVD was more higher as the progression of normal mucosa, esophagitis and esophageal squamous cell cancer. （2） Expression of survivin in esophageal squamous cell cancer was inversely correlated with the histological differentiation of tumor, lymph node metastasis and TNM stage （ P 〈 0.01 ）. Expression of HIF - 1α,HIF- 2α was positively related with lymph node metastasis（ P 〈 0.01 ） and histological differentiation of tumor （ P 〈 0.05 ）, inversely correlated with TNM stage （ P 〈 0.01 ）. （ 3 ） Expression of HIF - 1α, HIF - 2α and survivin were positively related with each other（ P 〈 0.01 ） and the MVD （ P 〈 0.01 ）. Conclusion （ 1 ） HIF - 1α, HIF - 2α and survivin were collaborative in progression of esophageal squamous cell cancer. （2） The detection of survivin maybe show important clinical value to evaluate the occurrence, progression and prognosis of esophageal squamous cell cancer. Hopefully, survivin can be a new target for genetic diagnosis and therapy.