胃癌组织缺氧诱导因子-1α与胰岛素样生长因子-Ⅱ表达对肿瘤血管生成的影响及预后评估

目的探讨胃癌组织中缺氧诱导因子-1α（HIF-1α）及胰岛素样生长因子-Ⅱ（IGF—Ⅱ）mRNA的表达水平及其与血管生成和预后的关系。方法采用原位杂交检测118例胃癌组织中HIF-1αmRNA和IGF—ⅡmRNA的表达情况,用免疫组化SP法标记CD34单克隆抗体,计算肿瘤微血管密度（MVD）。结果HIF—1αmRNA和IGF—ⅡmRNA在胃癌组织中的阳性表达率分别为49．2％和47．4％。且与胃癌临床侵袭转移病理指标均相关。HIF-1αmRNA和IGF-ⅡmRNA阳性表达者的MVD值,均高于阴性表达者;HIF-1αmRNA和IGF-ⅡmRNA表达呈正相关,MVD分别与HIF-1αmRNA和IGF—ⅡmRNA的表达水平呈正相关。HIF—1αmRNA和IGF—ⅡmRNA表达阳性及MVD值≥41．5个／0．72mm^2的患者的平均生存时间及5年生存率均低于表达阴性及MVD值〈41．5个／0．72mm^2者。结论HIF-1α与IGF—Ⅱ对胃癌的浸润转移,特别是对肿瘤血管形成具有重要作用,可作为预测患者预后和指导治疗的新途径。

Expressions of hypoxia inducible factor-1alpha and insulin-like growth factor-II in gastric carcinoma: correlation with angiogenesis and prognosis

OBJECTIVE: To investigate relationship between expressions of hypoxia inducible factor-1alpha (HIF-1alpha) and insulin-like growth factor-II (IGF-II) as well as their correlation with angiogenesis and prognosis in gastric carcinoma. METHODS: HIF-1alpha and IGF-II mRNA expression were analyzed using in situ hybridization, microvessel density (MVD) was determined by anti-CD34 immunostaining in 118 cases gastric carcinoma. RESULTS: The positive rates of HIF-1alpha mRNA and IGF-II mRNA were 49.2% and 47.4%, respectively. In stage T3-T4 cases, positive rates of HIF-1alpha and IGF-II mRNA expression, the frequencies of vessel invasion, lymph node and distant metastasis were significantly higher than those in stage T1-T2 cases. The mean MVD in stage T3-T4 tumors, vessel invasion, lymph node metastasis and distant metastasis were significantly more frequent than those in stage T1-T2 tumors. The mean MVD in tumors with positive HIF-1alpha and IGF-II mRNA expression was significantly higher than those in tumors without HIF-1alpha and IGF-II mRNA expression. The expression of HIF-1alpha was positively correlated with IGF-II mRNA. There were positive correlations between MVD and expression of HIF-1alpha and IGF-II mRNA, respectively. The mean survival time and 5-year survival rate in cases with positive HIF-1alpha and VEGF expression and MVD value >/= 41.5 were significantly shorter than those in cases with negative HIF-1alpha and VEGF expression and MVD value < 41.5. CONCLUSIONS: HIF-1alpha and IGF-II play an important role in tumor invasion and metastasis, especially in tumor angiogenesis. So test of the expression of HIF-1alpha and IGF-II may act as a useful index of treatment and prognosis.