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缺氧诱导因子1α在乳头状肾细胞癌中的表达及其与预后的关系

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  • a.上海交通大学医学院附属瑞金医院 泌尿外科,上海 200025
    b.上海交通大学医学院附属瑞金医院 病理科,上海 200025

收稿日期: 2021-04-27

  网络出版日期: 2022-06-28

Expression of HIF-1α and its relationship with prognosis in papillary renal cell carcinoma

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  • a. Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    b. Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2021-04-27

  Online published: 2022-06-28

摘要

目的:检测缺氧诱导因子1α(hypoxia-inducible factor-1ɑ,HIF-1α)在乳头状肾细胞癌(papillary renal cell carcinoma, PRCC)组织中的表达情况,分析其与微血管密度(microvessel density, MVD)间的关系,并探讨HIF-1α与患者预后间的关系。方法:应用免疫组织化学(免疫组化)技术检测PRCC组织和癌旁肾组织(对照)中HIF-1α及MVD表达,分析二者之间的相关性。采用Kaplan-Meier法和Logrank法对患者的生存数据进行分析,对有意义的因素行Cox模型多因素回归分析。结果:PRCC组织中HIF-1α的阳性表达率为42.17%(35/83),其中Ⅰ型、Ⅱ型PRCC组织中HIF-1α阳性表达率分别为32.65%、55.88%,二者间差异有统计学意义(P=0.035)。Ⅱ型PRCC组织中的MVD高于Ⅰ型PRCC(40.74个/高倍镜比25.63个/高倍镜),在Ⅰ型和Ⅱ型PRCC中,HIF-1α的表达均与MVD呈正相关(γ=0.65)。83例PRCC患者的5年生存率为89.16%(74/83),13例死亡的病例中,10例为Ⅱ型PRCC,采用Kaplan-Meier生存曲线分析显示,Ⅰ型PRCC患者的预后好于Ⅱ型PRCC(5年总体生存率87.8%比76.5%, P<0.05)。单因素分析显示,肾细胞癌Fuhrman核分级Ⅲ~Ⅳ级、肿瘤发生远处转移和HIF-1α阳性表达是PRCC患者预后不良的危险因素;多因素分析显示,Ⅱ型PRCC、Fuhrman核分级Ⅲ~Ⅳ级、肿瘤远处转移及HIF-1α阳性表达是PRCC预后不良的因素。结论:相对于Ⅰ型PRCC,HIF-1α在Ⅱ型PRCC组织中的阳性率更高,其阳性表达是PRCC患者预后不良的因素。

本文引用格式

芮文斌, 徐达, 祝宇, 吴瑜璇, 王浩飞, 汪成合, 袁菲 . 缺氧诱导因子1α在乳头状肾细胞癌中的表达及其与预后的关系[J]. 诊断学理论与实践, 2021 , 20(03) : 265 -370 . DOI: 10.16150/j.1671-2870.2021.03.007

Abstract

Objects: To investigate the expression of hypoxia inducible factor-1ɑ(HIF-1ɑ) in papillary renal cell carcinoma (PRCC) and its relationship with microvessel density so as to explore the correlation of HIF-1ɑ expression with prognosis in PRCC patients. Methods: Immunohistochemistry was used to detect the expression of HIF-1ɑ in PRCC and para-carcinoma tissue and the relationship between expression of HIF-1ɑ and MVD was analyzed. Survival data were eva-luated with Kaplan-Meier and Log-rank method, and the significant factors were further analyzed with Cox model multivariate regression analysis. Results: The positive expression rate of HIF-1ɑ was 42.17% (35/83), and the positive expression rates in typeⅠand type II PRCC were 32.65% and 55.88%, respectively. The MVD in typeⅡPRCC was higher than that in typeⅠPRCC (40.74 /HP vs 25.63/HP), and HIF-1ɑ expression was positively correlated with MVD (γ=0.65). The 5-year survival rate of 83 PRCC patients was 89.16% (74/83), and of the 13 death cases, 10 cases were type Ⅱ PRCC. The Kaplan-Meier survival curve analysis showed that typeⅠPRCC had a better prognosis than typeⅡ. Univariate analysis revealed that Fuhrman grade Ⅲ-Ⅳ, occurrence of distant metastasis and HIF-1ɑ expression were risk factors for prognosis in PRCC patients (P<0.05). Multivariate analysis showed that HIF-1ɑ expression, Fuhrman grade, subtype of PRCC and distant metastasis were risk factors for poor prognosis. Conclusions: HIF-1ɑ expression is higher in typeⅡPRCC than in typeⅠPRCC, and HIF-1ɑ expression is a risk factor for poor prognosis in PRCC patients.

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