Department of Radiology, University of the Ryukyus School of Medicine, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan.
Anticancer Res. 2011 Jun;31(6):2351-9.
We investigated whether hypoxia-inducible factor-1α (HIF-1 α) expression in pretreatment biopsies of esophageal cancer is predictive of clinical outcome in patients with esophageal cancer undergoing concurrent chemoradiotherapy (CRT).
A total of 25 patients were reviewed. Radiotherapy was administered to total doses of 40-66.6 Gy (median: 66.6 Gy) with a single fraction of 1.8-2 Gy. Cisplatin (80 mg/m2 on day 1) and 5-fluorouracil (800 mg/m2 on days 2-6) were administered concurrently with radiotherapy, every 3-4 weeks to a total of 1-2 courses. Tissue samples from esophageal cancer were obtained from all 25 patients by biopsy before concurrent CRT, and semiquantitative analyses of HIF-1α expression were performed using immunohistochemical staining.
High HIF-1α expression was observed in 11 out of 25 patients (42.7%), and HIF-1α expression was significantly correlated with initial response to CRT (p=0.0027). Patients with high HIF-1α expression had significantly poorer local control (LC) (5-year LC: 42.7%) than those with low expression (5-year LC: 72.5%; p=0.0322). Patients with high HIF-1α expression also had significantly lower recurrence-free survival (RFS) (5-year RFS: 18.2%) compared to those with low HIF-1α expression (5-year RFS: 39.8%; p=0.0009), and on multivariate analysis, HIF-1α (p=0.001) and number of chemotherapy courses (p=0.010) were independent prognostic factors for RFS.
HIF-1α expression is significantly correlated with initial response to concurrent CRT, and is predictive of RFS for patients with esophageal cancer receiving concurrent CRT.
我们研究了食管癌患者术前活检中缺氧诱导因子-1α（HIF-1α）的表达是否与接受同期放化疗（CRT）的食管癌患者的临床结局相关。
回顾性分析了 25 例患者。放疗剂量为 40-66.6 Gy（中位数：66.6 Gy），单次剂量 1.8-2 Gy。顺铂（第 1 天 80 mg/m2）和 5-氟尿嘧啶（第 2-6 天 800 mg/m2）与放疗同时进行，每 3-4 周一次，共 1-2 个疗程。所有 25 例患者在同步 CRT 前均通过活检获得食管癌组织标本，并采用免疫组织化学染色进行 HIF-1α表达的半定量分析。
25 例患者中有 11 例（42.7%）观察到高 HIF-1α表达，HIF-1α表达与 CRT 初始反应显著相关（p=0.0027）。高 HIF-1α表达的患者局部控制率（LC）显著较差（5 年 LC：42.7%），低于低表达患者（5 年 LC：72.5%；p=0.0322）。高 HIF-1α表达的患者无复发生存率（RFS）也显著低于低 HIF-1α表达的患者（5 年 RFS：18.2%对 5 年 RFS：39.8%；p=0.0009），多因素分析显示，HIF-1α（p=0.001）和化疗疗程数（p=0.010）是 RFS 的独立预后因素。
HIF-1α的表达与同期 CRT 的初始反应显著相关，是预测接受同期 CRT 的食管癌患者 RFS 的指标。
