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
Received date: 2021-04-27
Online published: 2022-06-28
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。
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
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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