Cai Cheng, Wang Jianping, Zhong Zhifeng, Dai Zhihui, Wang Qinghua, Dong Wuzhen, Shi Hongqi, Liu Qingwei, DU Jinlin
Department of Colorectal and Anal Surgery, Jinhua Municipal Central Hospital, Jinhua 321000, China.
Department of Pathology, Jinhua Municipal Central Hospital, Zhejiang University, Jinhua 321000, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2017 Jan 25;46(1):36-43. doi: 10.3785/j.issn.1008-9292.2017.02.06.
To investigate the expression of hypoxia-inducible factor 1α (HIF-1α) and CD133 in predicting pathologic remission and survival of patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy. One hundred and fourteen patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy from January 2010 to December 2015 in Jinhua Municipal Central Hospital were enrolled in the study. RT-PCR and immunohistochemistry methods were used to detect the mRNA and protein expression of HIF-1α and CD133 before and after chemoradiotherapy. Spearman rank correlation was used to analyze the correlation between HIF-1α and CD133 mRNA expression. Univariate and logistic multivariate analyses were used to determine the factors related to pathological complete response (pCR). Logistic regression analysis and Cox's proportional hazard model were used to determine factors related to overall survival and recurrence-free survival. The expression of HIF-1α and CD133 mRNA was correlated with pT, ypTNM, pCR, recurrence and metastasis of rectal cancer, while not correlated with sex, age and BMI of patients. HIF-1α mRNA expression was positively correlated with CD133 mRNA expression ( =0.579, =0.000). Immunohistochemistry analysis showed that residual cancer cells strongly expressing HIF-1α also expressed CD133 strongly. Univariate analysis showed that HIF-1α mRNA and CD133 mRNA were significantly correlated with pCR ( =0.001, =0.022, respectively). Multivariate analysis showed that HIF-1α and CD133 mRNA expression were independent prognostic factors of pCR ( =0.012, =0.047, respectively). Cox regression analysis showed that the expression of HIF-1α mRNA and CD133 mRNA were independent predictors of recurrence-free survival and overall survival ( =0.025, =0.033, respectively). The study indicates that HIF-1α and CD133 can predict pathological complete remission and survival of patients with locally advanced rectal cancer.
探讨缺氧诱导因子1α（HIF-1α）和CD133的表达在预测接受新辅助放化疗的局部晚期直肠癌患者病理缓解及生存情况中的作用。选取2010年1月至2015年12月在金华市中心医院接受新辅助放化疗的114例局部晚期直肠癌患者纳入研究。采用RT-PCR和免疫组化方法检测放化疗前后HIF-1α和CD133的mRNA及蛋白表达。采用Spearman秩相关分析HIF-1α与CD133 mRNA表达的相关性。采用单因素和logistic多因素分析确定与病理完全缓解（pCR）相关的因素。采用logistic回归分析和Cox比例风险模型确定与总生存和无复发生存相关的因素。HIF-1α和CD133 mRNA的表达与直肠癌的pT、ypTNM、pCR、复发和转移相关，而与患者的性别、年龄和BMI无关。HIF-1α mRNA表达与CD133 mRNA表达呈正相关（r = 0.579，P = 0.000）。免疫组化分析显示，强表达HIF-1α的残留癌细胞也强表达CD133。单因素分析显示，HIF-1α mRNA和CD133 mRNA与pCR显著相关（分别为P = 0.001，P = 0.022）。多因素分析显示，HIF-1α和CD133 mRNA表达是pCR的独立预后因素（分别为P = 0.012，P = 0.047）。Cox回归分析显示，HIF-1α mRNA和CD133 mRNA的表达是无复发生存和总生存的独立预测因素（分别为P = 0.025，P = 0.033）。该研究表明，HIF-1α和CD133可预测局部晚期直肠癌患者的病理完全缓解及生存情况。
