Hasbek Z, Ozer H, Erturk S A, Erdiş E, Yucel B, Çiftçi E, Çakmakcilar A
Cumhuriyet University, School of Medicine, Department of Nuclear Medicine, Sivas, Turquía.
Cumhuriyet University, School of Medicine, Department of Pathology, Sivas, Turquía.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2019 Nov-Dec;38(6):355-361. doi: 10.1016/j.remn.2019.05.006. Epub 2019 Oct 28.
The hypoxia-inducible factor 1 (HIF-1) has a critical role in oxygen homeostasis and it is a transcriptional activator of angiogenesis, erythropoiesis, iron and glucose metabolism. Glucose metabolism rate is increased in some tumours via HIF-1α. Our aim is to evaluate the relationship between hypoxia in colorectal cancer, PET parameters, necrotic tissue size and pathologic prognostic factors via using HIF-1α.
MATERIALS/METHODS: 70 patients (28 female/42 male; median age: 63 years) who were diagnosed with colorectal cancer via biopsy were staged with preoperative PET/CT and operated subsequently. Immunohistochemical evaluation scoring was done according to nuclear HIF-1α expression, staining density and intensity. Metabolic tumour volume (MTV), total lesion glycolysis (TLG) and tumour volume (TV) were calculated by using volume of an ellipsoid formula via CT images, and percentage of tumour necrosis (%TmNcr) that was calculated by the difference between TV and recorded MTV.
There was a moderately meaningful positive correlation between tumour SUVmax and TV and %TmNcr (r=0.403, p=0.001 and r=0.500, p=0.0001, respectively). There were no statistically significant relationships between HIF-1α expression levels and tumour SUVmax, TLG, MTV, TV, %TmNcr, tumour stage, lymphovascular invasion, perineural invasion and extracapsular/capsular lymph node involvement. On the other hand, strong nuclear immunohistochemical staining was seen in tumour cells adjacent to invasive border, inflammatory cells. Although not statistically significant, moderate or strong nuclear staining were seen in 64.9% of metastatic patients.
Although the presence of a positive correlation between tumour SUVmax and %TmNcr shows that there are hypoxic cells in cancer tissue with high FDG uptake, the relationship between the presence of HIF-1α and enhanced glucose metabolism and pathological prognostic factors of tumour was not shown. Strong nuclear immunohistochemical staining in tumour cells adjacent to invasive border and inflammatory cells leads us to believe that HIF-1α plays a role in the invasion area of tumour microenvironment.
缺氧诱导因子1（HIF-1）在氧稳态中起关键作用，是血管生成、红细胞生成、铁和葡萄糖代谢的转录激活因子。通过HIF-1α，一些肿瘤中的葡萄糖代谢率会升高。我们的目的是通过使用HIF-1α评估结直肠癌中的缺氧、PET参数、坏死组织大小与病理预后因素之间的关系。
材料/方法：70例经活检确诊为结直肠癌的患者（28例女性/42例男性；中位年龄：63岁），术前行PET/CT分期，随后接受手术。免疫组织化学评估评分根据细胞核HIF-1α表达、染色密度和强度进行。通过CT图像使用椭球体公式计算代谢肿瘤体积（MTV）、总病变糖酵解（TLG）和肿瘤体积（TV），并通过TV与记录的MTV之间的差值计算肿瘤坏死百分比（%TmNcr）。
肿瘤SUVmax与TV和%TmNcr之间存在中度显著的正相关（分别为r=0.403，p=0.001和r=0.500，p=0.0001）。HIF-1α表达水平与肿瘤SUVmax、TLG、MTV、TV、%TmNcr、肿瘤分期、淋巴管侵犯、神经周围侵犯和包膜外/包膜内淋巴结受累之间无统计学显著关系。另一方面，在侵袭边界附近的肿瘤细胞、炎症细胞中可见强细胞核免疫组织化学染色。虽然无统计学显著差异，但64.9%的转移患者可见中度或强细胞核染色。
虽然肿瘤SUVmax与%TmNcr之间存在正相关表明高FDG摄取的癌组织中存在缺氧细胞，但未显示HIF-1α的存在与增强的葡萄糖代谢及肿瘤病理预后因素之间的关系。侵袭边界附近的肿瘤细胞和炎症细胞中的强细胞核免疫组织化学染色使我们相信HIF-1α在肿瘤微环境的侵袭区域起作用。
