Lin Chang-Sheng, Liu Tu-Chen, Lee Ming-Tsung, Yang Shun-Fa, Tsao Thomas Chang-Yao
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Department of Chest Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan.
Int J Med Sci. 2017 Jul 18;14(8):785-790. doi: 10.7150/ijms.19512. eCollection 2017.
Hypoxia is an important factor in tumor angiogenesis, metastasis, and resistance to chemotherapy or radiotherapy, and may be an indicator of poor prognosis. The transcription factor hypoxia-inducible factor 1 (HIF-1) is the key regulator of the hypoxic state. This study was designed to evaluate the prognostic value of HIF-1α expression in small cell lung cancer (SCLC). Forty-three paraffin-embedded biopsy materials were examined using immunohistochemistry. Our results indicated that the expression of HIF-1α was high in males, and patients with poor Eastern Cooperative Oncology Group (ECOG) performance status and metastases. To elucidate the prognostic value of HIF-1α expression, Kaplan-Meier analysis was carried out and the results showed that patients with high HIF-1α expression had a poorer prognosis than patients with low expression of HIF-1α. After adjusting clinical parameters by the Cox proportional hazards model, our results demonstrated that high HIF-1α expression is an independent prognostic factor for SCLC with a 39.2-fold risk of death (p<0.003). In conclusion, we have provided evidence that HIF-1α expression has significant value in predicting survival of patients with SCLC and is an independent prognostic factor beyond ECOG performance and metastasis status.
缺氧是肿瘤血管生成、转移以及对化疗或放疗产生抗性的重要因素，并且可能是预后不良的一个指标。转录因子缺氧诱导因子1（HIF-1）是缺氧状态的关键调节因子。本研究旨在评估HIF-1α表达在小细胞肺癌（SCLC）中的预后价值。使用免疫组织化学方法检测了43份石蜡包埋的活检材料。我们的结果表明，HIF-1α在男性、东部肿瘤协作组（ECOG）体能状态差和有转移的患者中表达较高。为了阐明HIF-1α表达的预后价值，进行了Kaplan-Meier分析，结果显示HIF-1α高表达的患者比HIF-1α低表达的患者预后更差。通过Cox比例风险模型调整临床参数后，我们的结果表明，HIF-1α高表达是SCLC的一个独立预后因素，死亡风险为39.2倍（p<0.003）。总之，我们提供了证据表明，HIF-1α表达在预测SCLC患者的生存方面具有重要价值，并且是一个独立于ECOG体能状态和转移状态的预后因素。
