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目的:本研究旨在探讨横纹肌肉瘤(rhabdomyosarcoma,RMS)组织中缺氧诱导因子-1α(hypoxiainducible factor-1alpha,HIF-1α)和血管内皮生长因子(vascular endothelial growth factor,VEGF)的表达及临床意义。方法:采用免疫组织化学法检测70例RMS组织HIF-1α和VEGF的表达,分析其与RMS患者临床病理特征及预后的相关性。结果:RMS组织中HIF-1α阳性表达率为75.7%(53/70),VEGF阳性表达率为72.9%(51/70)。统计结果显示,HIF-1α和VEGF的表达呈正相关(r=0.554,P=0.000)。HIF-1α蛋白表达与RMS患者的性别(P=0.035)、肿瘤大小(P=0.016)、分期(P=0.008)有相关性,但与患者的年龄(P=0.555)、病理亚型(P=0.625)及淋巴结转移(P=0.750)无相关性;HIF-1α蛋白表达阴性组与表达阳性组患者的3年总生存率分别为54.5%及38.0%(P=0.045)。VEGF蛋白表达与RMS患者的分期有相关性(P=0.026),但与患者的年龄(P=0.478)、性别(P=0.944)、肿瘤大小(P=0.535)、病理亚型(P=0.399)及淋巴结转移(P=0.356)无相关性;VEGF蛋白表达阴性组与表达阳性组患者的3年总生存率分别为68.1%及31.1%(P=0.011)。COX回归分析显示,VEGF表达、肿瘤分期和肿瘤大小是RMS的独立不良预后因素(P分别为0.005、0.004和0.000),而HIF-1α尚不能作为RMS的独立不良预后因素(P=0.845)。结论:RMS组织中存在HIF-1α蛋白和VEGF蛋白的高表达,与肿瘤分期有关;HIF-1α和VEGF的表达存在相关性;VEGF的表达是RMS独立的不良预后因素。
Objective: To investigate the expression and clinical significance of hypoxia-inducible factor-1alpha (HIF-1alpha) and vascular endothelial growth factor (VEGF) in rhabdomyosarcoma (RMS) . Methods: The expressions of HIF-1α and VEGF in 70 RMS tissues were detected by immunohistochemistry, and their correlation with clinicopathological features and prognosis was analyzed. Results: The positive expression rate of HIF-1α in RMS tissue was 75.7% (53/70), the positive rate of VEGF was 72.9% (51/70). The statistical results showed that there was a positive correlation between the expression of HIF-1α and VEGF (r = 0.554, P = 0.000). HIF-1αprotein expression was correlated with age (P = 0.055), tumor size (P = 0.016) and stage (P = 0.008) = 0.625) and lymph node metastasis (P = 0.750). The 3-year overall survival rates were 54.5% and 38.0% (P = 0.045) respectively in patients with negative HIF-1α protein expression and positive expression. There was a significant correlation between the expression of VEGF and the stage of RMS (P = 0.026), but not with age (P = 0.478), sex (P = 0.944), tumor size ) And lymph node metastasis (P = 0.356). The 3-year overall survival rates were 68.1% and 31.1% (P = 0.011) respectively in patients with VEGF protein expression negative group and positive expression group. COX regression analysis showed that VEGF expression, tumor stage and tumor size were independent adverse prognostic factors of RMS (P = 0.005, 0.004 and 0.000, respectively), while HIF-1α was not yet an independent adverse prognostic factor for RMS (P = 0.845). Conclusion: The high expression of HIF-1α protein and VEGF protein in RMS tissue correlated with tumor staging. The expression of HIF-1α was correlated with the expression of VEGF. The expression of VEGF was an independent adverse prognostic factor of RMS.