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目的分析人乳头瘤病毒(HPV)感染与缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)在头颈部鳞癌(HNSCC)组织中的表达,探讨HPV感染与HIF-1α、VEGF表达的关系及临床意义。方法对43例HNSCC标本采用原位杂交法检测HPV 6/11、16/18和31/33的感染情况;免疫组织化学法检测HIF-la和VEGF的表达。采用Spearman法进行等级相关分析,Kaplan-Meier法计算生存率,Cox模型多因素预后分析。结果 43例HNSCC患者中,HPV阳性感染者占25.6%,HIF-1α和VEGF的阳性表达率分别为65.1%和51.2%。HIF-1α的表达与T、N分期及临床分期有关(P<0.05),VEGF表达与N分期和复发有关(P<0.05)。相关分析显示,HNSCC组织中HIF-1α与VEGF表达呈正相关(r=0.359,P<0.05)。HPV阳性感染组与阴性感染组中HIF-1α和VEGF的表达率差异无统计学意义(P<0.05)。HPV阳性感染组和阴性感染组3年生存率分别为60.0%和59.7%(P>0.05),HIF-1α阳性表达组和阴性表达组3年生存率分别为49.9%和80.0%(P=0.060),VEGF阳性表达组和阴性表达组3年生存率分别为41.2%和81.0%(P<0.05)。结论 HIF-1α、VEGF可作为评估HNSCC发展、转移及预后的参考指标之一,尚不能明确HNSCC组织中HPV感染与HIF-1α、VEGF表达存在相关性。
Objective To investigate the expression of human papillomavirus (HPV) infection and hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in head and neck squamous cell carcinoma (HNSCC) 1α, VEGF expression and its clinical significance. Methods In 43 HNSCC specimens, the infection of HPV 6/11, 16/18 and 31/33 was detected by in situ hybridization. The expressions of HIF-1a and VEGF were detected by immunohistochemistry. Spearman’s rank correlation analysis, Kaplan-Meier’s survival rate and Cox’s multivariate prognostic analysis were used. Results Among 43 HNSCC patients, 25.6% were positive for HPV infection, and the positive rates of HIF-1α and VEGF were 65.1% and 51.2% respectively. The expression of HIF-1α was related to T, N staging and clinical stage (P <0.05), and VEGF expression was related to N stage and recurrence (P <0.05). Correlation analysis showed that there was a positive correlation between the expression of HIF-1α and VEGF in HNSCC (r = 0.359, P <0.05). There was no significant difference in the expression rates of HIF-1α and VEGF between HPV positive and negative groups (P <0.05). The 3-year survival rate was 60.0% and 59.7% respectively in HPV positive and negative groups (P> 0.05). The 3-year survival rates were 49.9% and 80.0% in HIF-1αpositive and negative groups (P = 0.060 ). The 3-year survival rates of VEGF-positive group and negative-expression group were 41.2% and 81.0% respectively (P <0.05). Conclusions HIF-1α and VEGF can be used as a reference index for assessing the development, metastasis and prognosis of HNSCC. However, it is unclear whether there is a correlation between HPV infection and the expression of HIF-1α and VEGF in HNSCC tissues.