目的：阐明CD133表达在胃癌中的临床意义，并初步探讨CD133与缺氧诱导因子-1α（HIF-1α）表达的相关性。方法该研究纳入长沙市第四医院医院189例胃癌患者，免疫组织化学法检测CD133和HIF-1α的表达。根据免疫组织化学法结果将患者分为CD133阴性表达组、L型CD133阳性表达组和C型CD133阳性表达组，并比较3组患者的临床病理特征、预后及HIF-1α表达。结果 C型CD133阳性表达组与胃癌转移、进展相关，L型CD133阳性表达组与胃癌转移、进展无关。C型CD133阳性表达患者生存率显著低于CD133阴性表达组患者，辅助化疗组和根治性切除组的生存率也有同样的结果。多元回归分析显示，细胞质表达的CD133是胃癌的独立预后因素。L型CD133管腔表达患者HIF-1α阳性率较低，而C型CD133表达患者HIF-1α阳性率较高。结论 C型CD133表达胃癌细胞是高潜能恶性肿瘤，该表现型与癌症进程、化疗耐药性、复发性及差预后相关，与HIF-1α表达呈正相关，C型CD133细胞质可能是胃癌潜在的预后标志物。%Objective To clarify the clinical role of CD133 expression in gastric cancer and to investigate the correlation between CD133 expression and hypoxia inducible factor (HIF)-1α expression. Methods Totally 189 gastric cancer patients who underwent gastrectomy in the Fourth Hospital of Changsha City were studied. CD133 and HIF-1α expressions were examined using immunohistochemical staining. Fifty-six cases were CD133-positive, and they were divided into two expression types: luminal expression of the gland and cyto-plasmic expression. The clinicopathological variables, prognosis and HIF-1a expression were compared among the three groups of different CD133-expression types. Results The expression of CD133 in the cytoplasm was correlated to metastasis and tumor progression. However, this relationship was not observed with luminal ex-pression type of the gland. The survival rate in the patients with cytoplasmic CD133 expression was signifi-cantly lower than that in the CD133-negative group. The same relationship was observed in the survival rate of the adjuvant chemotherapy group and the curative resection group. Multivariate analysis revealed that the expression of CD133 in the cytoplasm was an independent prognostic factor for gastric cancer. HIF-1α posi-tive rate was higher in the patients with cytoplasmic CD133 expression than in those with luminal CD133 expression. Conclusions Gastric cancer cells with CD133 expression in the cytoplasm have high potential for malignancy, and this phenotype is associated with cancer progression, chemotherapy resistance, recurrence and poor prognosis. Cytoplasmic expression of CD133 may be a useful prognostic marker for gastric cancer. A sig-nificant correlation is observed between HIF-1α expression and the immunohistochemical staining pattern of CD133.
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