Huang Zhichao, Xu Ran, Lv Chen, Zhong Zhaohui, Zhang Lei, Zhu Liang, Tang Yongzhong, Zhao Xiaokun
Department of Urology, The Second Xiangya Hospital, Central South University Changsha 410011, Hunan, China.
Department of Urology, Shanghai Changhai Hospital 168 Changhai Road, Shanghai 200433, China.
Int J Clin Exp Med. 2014 Oct 15;7(10):3344-53. eCollection 2014.
In this study, we investigated the relationship between the expression of hypoxia inducible factor-1α (HIF-1α) and tumor hypoxia, which is caused by chronic hypoxemic hypoxia in chronic obstructive pulmonary disease (COPD), and the prognostic value of COPD in patients with bladder urothelial carcinoma (BUC).
The clinicopathological variables of 80 patients with BUC who underwent surgery were analyzed by retrospective methods. Overall survival (OS), disease-specific survival (DSS) and progression-free survival (PFS) were analyzed with clinicopathological variables including concomitant COPD, pulmonary function test (PFT), serum hemoglobin level and smoking history, using Kaplan-Meier survival analysis. The Cox proportional hazards regression model was used for multivariate analysis. The localization of HIF-1α expression was analyzed by immunohistochemistry.
Both the median OS and PFS of patients with COPD were shorter than the patients without COPD (P < 0.001). High levels of HIF-1α expression were associated with BUC of higher clinicopathological stage and histological grade (P < 0.001). COPD was an independent prognostic variable for OS, PFS and DSS. The clinicopathological stage was an independent prognostic variable for OS and DSS. The level of HIF-1α expression was an independent prognostic variable for PFS.
COPD is an independent prognostic variable for BUC, and contributes to poor prognosis.
在本研究中，我们调查了缺氧诱导因子-1α（HIF-1α）的表达与慢性阻塞性肺疾病（COPD）所致慢性低氧性缺氧引起的肿瘤缺氧之间的关系，以及COPD对膀胱尿路上皮癌（BUC）患者的预后价值。
采用回顾性方法分析80例行手术治疗的BUC患者的临床病理变量。使用Kaplan-Meier生存分析，对包括合并COPD、肺功能测试（PFT）、血清血红蛋白水平和吸烟史在内的临床病理变量进行总生存期（OS）、疾病特异性生存期（DSS）和无进展生存期（PFS）分析。采用Cox比例风险回归模型进行多变量分析。通过免疫组织化学分析HIF-1α表达的定位。
COPD患者的中位OS和PFS均短于无COPD的患者（P < 0.001）。HIF-1α高表达与临床病理分期较高和组织学分级较高的BUC相关（P < 0.001）。COPD是OS、PFS和DSS的独立预后变量。临床病理分期是OS和DSS的独立预后变量。HIF-1α表达水平是PFS的独立预后变量。
COPD是BUC的独立预后变量，并导致预后不良。
