【摘要】 目的探讨缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)在不同糖代谢状态的乳腺癌患者中的表达及其与微血管生成的相关性。方法选择2013年1月—2015年6月湖州市中心医院收治的187例乳腺癌患者,根据血糖水平分为糖尿病组(DM组)67例、糖调节受损组(IGR组)50例、糖耐量正常组(NGT组)70例。采集临床资料、乳腺癌病理指标,检测癌组织HIF-1α和VEGF蛋白的表达,测定微血管密度(MVD),并分析相关性。结果 BMI、FPG、2 h PG、Hb A1c、HOMA-IR在NGT组、IGR组、DM组的水平均逐渐升高(P<0.05)。IGR组、DM组的肿瘤>2 cm及淋巴结转移的比例均显著高于NGT组(P<0.05)。但IGR组和DM组淋巴结转移的阳性率及肿瘤大小>2 cm的比例之间的差异无统计学意义(均P>0.05)。DM组HIF-1α和VEGF的阳性表达率均显著高于NGT组(P<0.05),而DM组与IGR组之间的差异无统计学意义(P>0.05)。NGT、IGR、DM组的MVD计数逐渐升高,DM组最高,NGT组最低(P<0.05)。HIF-1α阳性患者中,VEGF在NGT、IGR、DM组的阳性表达率分别为72.0%、84.2%、96.7%,呈升高趋势(P<0.01),且MVD亦呈升高趋势(P<0.01),而在HIF-1α阴性患者中,VEGF阳性表达率、MVD水平在NGT、IGR、DM组间的差异均无统计学意义(均P>0.05)。结论HIF-1α可能具有促进乳腺癌合并2型糖尿病患者癌组织中微血管的生成的作用,监测HIF-1α水平可能对乳腺癌的浸润转移及增殖具有一定的预测意义。更多还原

【Abstract】 Objective To investigate the expression of hypoxia-inducible factor-1α( HIF-1α) and vascular endothelial growth factor( VEGF) in breast cancer patients with different glucose metabolic status and their correlation with microvascular production. Methods The clinical data of 187 patients with breast cancer from January,2013 to June,2015 were retrospectively analyzed. According to the blood glucose level,67 patients were assigned into diabetic patients( DM group),50 patients with impaired glucose regulation in IGR Group,and 70 patients with normal glucose tolerance in NGT group. The expression of HIF-1α and VEGF protein was detected by immunohistochemistry. The microvessel density( MVD) was measured and its correlation with the levels of HIF-1α and VEGF protein was analyzed. Results The levels of BMI,FPG,2 h PG,Hb A1 C and HOMA-IR among NGT group,IGR group and DM group were significant different and the latter group was higher than the previous group( P < 0. 05). In IGR and DM group,the proportion of lymph node metastasis and tumor > 2 cm was significantly higher than that in NGT group( P < 0. 05),however,there was no significant difference between the positive rate of lymph node metastasis and the size of tumor larger than 2 cm between IGR group and DM group( P > 0. 05). The positive expression rates of HIF-1α and VEGF in DM group were significantly higher than those in NGT group( P < 0. 05),but there was no significant difference between DM group and IGR group( P > 0. 05). Among the three groups,the number of MVD in NGT was lowest,in DM group was highest,the differences were statistically significant( P < 0. 05). In HIF-1α positive patients,the positive rates of VEGF expression in NGT,IGR and DM groups were 72. 0%,84. 2% and 96. 7%,respectively( P < 0. 01),and MVD level was also increased( P < 0. 01). However,there was no significant difference in the expression of VEGF and MVD between NGT,IGR and DM in HIF-1α negative patients( P > 0. 05). Conclusion HIF-1α may play an important role in promoting the formation of microvessels in breast cancer patients with type 2 diabetes mellitus. Monitoring HIF-1α may play an important role in predicting the invasion and metastasis of breast cancer.更多还原