CAJ | 학술논문

目的观察缺氧诱导因子-1α(HIF-1α)在视网膜母细胞瘤(RB)中表达分布的区域性及其与血管内皮生长因子(VEGF)、Ki-67、Bax的关系。方法病理检查确诊的39例RB患儿的石蜡标本纳入研究。采用免疫组织化学EnVision法检测HIF-1α、VEGF、Bax和Ki-67在RB中的表达。按照肿瘤区域分为表面区、中央区、基底部、脉络膜区及子瘤5个区域，分析上述检测指标在肿瘤的表达、分布差异及相关性。结果 39例RB标本中，HIF-1α表达阴性者10例，占25.6％；阳性者29例，占74.4％。其中，1+者17例，占43.6％；2+者12例，占30.8％。表面区、中央区、基底部、脉络膜区及子瘤区染色阳性者分别占71.1％、36.8％、84.2％、54.5％、82.1％。不同区域间阳性表达率分布比较，差异有统计学意义(X2=24.55，P＜0.001)。VEGF、Bax和Ki-67表达阳性率分别为53.8％、66.7％、59.0％。其中,VEGF和Bax在不同区域的阳性表达率差异均有统计学意义（X2=26.77，22.79;P＜0.001）；Ki-67在不同区域阳性表达率差异无统计学意义（X2=0.47，P=0.976）。HIF-1α与VEGF和Bax的表达呈正相关(rs=0.48，0.39；P=0.002，0.021)，而与Ki-67的表达无明显相关(rs=0.09，P=0.606)。在不同区域，VEGF和Bax的表达均与HIF-1α有较好的一致性，即在肿瘤的表面区、基底部及子瘤区阳性率较高，在肿瘤的中央区和脉络膜区阳性率较低，而Ki-67与HIF-1α表达阳性率在不同区域无明显一致性。结论缺氧现象多分布在RB瘤体的边缘地带，且HIF-1α的表达在区域上与VEGF和Bax的表达成正相关关系。
목적 관찰결양유도인자-1α(HIF-1α)재시망막모세포류(RB)중표체분포적구역성급기여혈관내피생장인자(VEGF)、Ki-67、Bax적관계。방법 병리검사학진적39례RB환인적석사표본납입연구。채용면역조직화학EnVision법검측HIF-1α、VEGF、Bax화Ki-67재RB중적표체。안조종류구역분위표면구、중앙구、기저부、맥락막구급자류5개구역，분석상술검측지표재종류적표체、분포차이급상관성。결과 39례RB표본중，HIF-1α표체음성자10례，점25.6％；양성자29례，점74.4％。기중，1+자17례，점43.6％；2+자12례，점30.8％。표면구、중앙구、기저부、맥락막구급자류구염색양성자분별점71.1％、36.8％、84.2％、54.5％、82.1％。불동구역간양성표체솔분포비교，차이유통계학의의(X2=24.55，P＜0.001)。VEGF、Bax화Ki-67표체양성솔분별위53.8％、66.7％、59.0％。기중,VEGF화Bax재불동구역적양성표체솔차이균유통계학의의（X2=26.77，22.79;P＜0.001）；Ki-67재불동구역양성표체솔차이무통계학의의（X2=0.47，P=0.976）。HIF-1α여VEGF화Bax적표체정정상관(rs=0.48，0.39；P=0.002，0.021)，이여Ki-67적표체무명현상관(rs=0.09，P=0.606)。재불동구역，VEGF화Bax적표체균여HIF-1α유교호적일치성，즉재종류적표면구、기저부급자류구양성솔교고，재종류적중앙구화맥락막구양성솔교저，이Ki-67여HIF-1α표체양성솔재불동구역무명현일치성。결론 결양현상다분포재RB류체적변연지대，차HIF-1α적표체재구역상여VEGF화Bax적표체성정상관관계。
Objective To observe the regional expression of hypoxia inducible factor-1α (HIF-1α) in retinoblastoma and its relationships with vascular endothelial growth factor (VEGF), Bax and Ki-67.MethodsImmunohistochemical study for HIF-lα, VEGF, Bax and Ki-67 was performed in 39paraffinaceous examples of retinoblastoma. Each pathological section was divided into five regions: the surface region, the central part, the bottom part, the choroidal region and seeding tumors. The expressions, correlations and distributional differences of these factors were all invested both integrally and regionally. Results In the 39 cases of retinoblastoma, 10 cases (25.6％) were negative for HIF-1α; 29cases (74.4％) were positive for HIF-1α, including 17 cases (43.6％) (+), 12 cases (30.8％) (++).Regionally, HIF-1α was positive in 71.1％, 36.8％, 84.2％, 54.5％ and 82.1％ of the cases in the surface region, the central part, the bottom part, the choroidal region and seeding tumors, respectively, which was statistically reliable (X2 =24.55, P＜0. 001). The positive rate of VEGF, Bax and Ki-67 was 53. 8％,66.7％ and 59.0％, respectively. In different regions, the positive rates of VEGF and Bax were different (X2=26.77, 22.79; P＜0. 001), but there was no regional distinctions in the expression of Ki-67 (X2=0. 47, P=0. 976). Both the expression of VEGF and Bax had a positive correlation with that of HIF-1α(rs=0. 48, 0.39; P=0.002, 0. 021), but there was no relationship between the expressions of Ki-67and that of HIF-1α (rs=0. 09, P=0. 606). Regionally, the expressions of VEGF, Bax and HIF-1α shared similar distributional features: positive rates were higher in the surface region, bottom part and seeding tumors, and were lower in the central part and choroidal region, which was different from the expression of Ki-67. Conclusion The anoxic zones are more likely to be located in the marginal parts in retinoblastoma,and the expressions of VEGF and Bax had a positive correlation with that of HIF-1α in different regions in retinoblastoma.