摘要
目的探讨食管鳞癌组织中HIF-1α、VEGF和EGFR蛋白的表达与预后的关系。方法回顾性分析宁夏医科大学总医院自2011年1月至2014年5月间收治的食管鳞癌患者73例，其中放射治疗36例、手术＋辅助性放疗21例、手术后局部复发以及区域复发放疗16例。采用3D—CRT30例，IMRT43例。放疗中位剂量58Gv。应用免疫组化sP法检测73例食管鳞癌组织中HIF-1α、VEGF和EGFR蛋白表达，同时于37例手术标本中随机抽取14例，取其手术切缘正常组织作为对照组。采用SPSS17．0统计软件，计数资料进行z。检验，Kaplan—Meier法计算生存率并Log—rank法检验和单因素预后分析，Cox法多因素预后分析。结果HIF-1α、VEGF、EGFR在全组食管鳞癌组织中的阳性表达为分别70．0％、84．9％、80．8％，而在癌旁正常组织中的阳性表达分别为14．3％、14．3％、28．6％，差异有统计学意义（均P〈0．05）。全组1、2、3年OS和PFS分另0为80．7％、36．1％、2212％和37．0％、21．5％、19．7％。中位OS时间为21个月（95％CI为17．1—24．9个月），中位PFS时间为9个月（95％CI为6．1—11．9个月）。多因素分析发现VEGF表达情况是影响PFS的因素（P=0．038）。结论HIF-1α、VEGF和EGFR在食管鳞癌中阳性表达率均高，VEGF表达情况是影响生存的因素。
Objective To investigate the relationship of the prognosis and expressions of HIF-1α, VEGF, and EGFR proteins in esophageal squamous cell carcinoma. Methods From January, 2011 to May, 2014, 73 patients with esophageal squamous cell carcinoma were retrospective analyzed for whom they were treated in the Tumor Hospital of General Hospital of Ningxia Medical University. Among them, 36 patients were only underwent radiation therapy, 21 for both surgery and radiation therapy, and the rest for recurrence after local resection of tumor and recurrence after local radiotherapy. 3D-CRT was adopted in 30 patients, while IMRT was used in 43 patients. The median radiation dose was 58 Gy. Using S-P immunohistochemistry tested the expressions of HIF- lct, VEGF, and EGFR proteins of esophageal squamous carcinoma in all the patients. Meanwhile, 14 operation samples were collected randomly in the 37 operated patients for getting the normal esophageal tissues in the incisal edges as the control group. SPSS17.0 statistical software was applied to chi-square test, to calculate the survival rate by Kaplan-Meier method, Log-rank test, and prognosis analysis of multiple factors by Cox. Results The positive rates of the expressions of HIF-1α,VEGF, and EGFR were 70.0%, 84.9%, and 80.8% respectively, while those in the adjacent normal tissues were 14.3%, 14.3%, and 28.6% individually （P 〈 0.05）. The overall survival （OS） was 80.7%, 36.1%, and 22.2% in the first year, the second year, and the third year, the progression free survival （PFS） was 37.0%, 21.5%, and 19.7% respectively in the first year, the second year, and the third year. The median OS was 21 months （95% CI： 17.1-24.9 months）, while the median PFS was 9 months （95% CI： 6.1-11.9 months）. The prognosis analysis of multiple factors demonstrated that VEGF expression held the leading role in PFS （P = 0.038）. Conclusions The positive expressions of HIF-1α, VEGF, and EGFR in esophageal carcinoma increased. Among them, VEGF expression is the key factor to influence survival.
出处
《国际医药卫生导报》
2018年第3期297-307,共11页
International Medicine and Health Guidance News
基金
宁夏自然科学基金项目（NZ1246）
作者简介
通信作者：赵仁，E—mail：zhaorendocter@126．com
