缺氧诱导因子-1α预测新辅助放化疗直肠癌患者病理完全缓解及预后的价值

摘要

Objective To assess the value of hypoxia-inducible factor 1α (HIF-1α) for predicting pathological response and clinical outcomes in rectal cancer patients treated with neoadjuvant chemoradiotheray (nCRT).Methods One hundred and fourteen patients with rectal cancer receiving nCRT before surgery from January 2010 to December 2015 were enrolled in the study.The expression of HIF-1α in tumor tissue was examined with immunohistochemistry.The predictive factors of pathological complete response (pCR),3-year recurrence-free survival and 3-year overall survival were analyzed.Results The high expression of HIF-1α was detected in 60 cases (52.6％).The expression of HIF-1α was correlated with tumor diameter before treatment and pCR(P＜0.05),not correlated to gender,age,BMI,distance from tumor to anus,T stage and N stage(all P ＞0.05).Multivariate logistic regression analysis showed that HIF-1α expression was correlated with pCR (P＜0.05).HIF-1α expression and ypTNM staging were correlated with 3-year recurrence free survival rate and 3-year overall survival rate (P＜0.05).Cox proportional risk regression model showed that the expression of HIF-1α was an independent predictor for recurrence free survival and overall survival (all P＜0.05).Conclusion HIF-1α can predict the efficacy of nCRT,and the prognosis of patients with rectal cancer.%目的 评估缺氧诱导因子-1α(HIF-1α)预测新辅助放化疗(nCRT)直肠癌患者病理完全缓解(pCR)及预后的价值.方法 对114例直肠癌患者行nCRT后手术切除的肿瘤标本采用免疫组化法检测HIF-1α表达,分析HIF-1α表达与患者临床病理特征的关系,以及患者的病理完全缓解(pCR)、3年无复发生存率、3年总生存率相关预测因子.结果 60例患者HIF-1α呈高表达,占52.6％.HIF-1α表达与患者性别、年龄、BMI、肿瘤距肛门距离、T分期、N分期均无关(均P＞0.05);但与治疗前肿瘤直径、pCR有关(均P＜0.05).经多因素logistic回归分析,HIF-1α表达与pCR相关(P＜0.05),ypTNM分期、HIF-1α表达与患者3年无复发生存率、3年总生存率均相关(均P＜0.05).经Cox比例风险回归模型分析,HIF-1α表达是患者3年无复发生存、总生存的独立预测因子(均P＜0.05).结论 HIF-1α能预测直肠癌nCRT的疗效,或在患者选择及疗效评估中发挥重要作用.