摘要
目的 分析L1细胞黏附分子(L1CAM)、缺氧诱导因子-1α(HIF-1α)在宫颈癌组织中的表达水平及与患者病理特点、预后的关系。方法 选取2021年2月—2023年2月在温岭市中医院就诊的94例宫颈癌患者为观察组,体检的92例健康女性为对照组。比较两组宫颈组织中L1CAM、HIF-1α表达水平。根据观察组宫颈癌组织中L1CAM表达水平,分为L1CAM高表达组(53例)和低表达组(41例);根据观察组宫颈癌组织中HIF-1α表达水平,分为HIF-1α高表达组(56例)和低表达组(38例)。比较L1CAM高表达组与低表达组、HIF-1α高表达组与低表达组的病理特点,均采用手术治疗,术后随访2年。采用Cox回归模型分析宫颈癌患者术后复发、转移的影响因素。结果 观察组L1CAM、HIF-1α高表达率(56.38%、59.57%)均高于对照组(3.26%、5.43%),差异均有统计学意义(χ^(2)=62.352、61.833,均P<0.05)。L1CAM高表达组临床分期Ⅲ期、低分化、淋巴结转移、脉管转移比例(49.06%、69.81%、62.26%、54.72%)均高于低表达组(26.83%、26.83%、34.15%、24.39%),差异均有统计学意义(χ^(2)=4.785、28.035、7.311、8.758,均P<0.05)。HIF-1α高表达组肿瘤直径>10 mm、低分化、淋巴结转移比例(62.50%、67.86%、62.50%)均高于低表达组(18.42%、26.32%、31.58%),差异均有统计学意义(χ^(2)=17.795、16.109、8.658,均P<0.05)。随访2年,观察组中14例患者出现术后复发、转移,80例患者未出现术后复发、转移。Cox单因素分析结果显示:HIF-1α高表达、L1CAM高表达、肿瘤大小、临床分期均为宫颈癌患者术后复发、转移的影响因素(均P<0.05)。Cox多因素回归模型显示:HIF-1α高表达、L1CAM高表达、临床分期(Ⅲ期)是宫颈癌患者术后复发、转移的影响因素(均P<0.05)。结论 在宫颈癌组织中,L1CAM、HIF-1α呈高表达。宫颈癌组织中L1CAM表达水平与临床分期、淋巴结转移、脉管转移、分化程度有关;宫颈癌组织中HIF-1α表达水平与淋巴结转移、肿瘤直径、分化程度有关。L1CAM、HIF-1α表达水平以及临床分期是宫颈癌术后复发、转移的独立影响因素。
Objective To analyze the expression levels of L1 cell adhesion molecule(LICAM)and hypoxia-inducible factor-1(HIF-1α)in cervical cancer tissues and the relationships with pathological characteristics and prognosis of cervical cancer patients.Meth-ods A total of 94 patients with cervical cancer who visited Wenling Traditional Chinese Medicine Hospital from February 2021 to February 2023 were selected as observation group,and 92 healthy women who underwent physical examination were selected as control group.The ex-pression levels of LICAM and HIF-1α in cervical tissues of the two groups were compared.According to the expression level of LICAM in cervical cancer tissues of observation group,the patients were divided into LICAM high expression group(53 cases)and low expression group(41 cases).According to the expression level of HIF-1α in cervical cancer tissues of observation group,the patients were divided into HIF-1α high-expression group(56 cases)and low-expression group(38 cases).The pathological characteristics of LICAM high-ex-pression group and low-expression group,as well as HIF-1α high-expression group and low-expression group were compared.All the patients with cervical cancer were treated with surgery and followed up for 2 years after the operation.Cox regression model was used to analyze the influencing factors of postoperative recurrence and metastasis in patients with cervical cancer.Results The high expression rates of LICAM and HIF-1α in observation group(56.38%,59.57%)were higher than those in control group(3.26%,5.43%),and the differ-ences were statistically significant(X^(2)=62.352,61.833,P<0.05).The proportions of clinical stage II,poorly differentiated,lymph node metastasis,and vascular metastasis in LICAM high expression group(49.06%,69.81%,62.26%,54.72%)were all higher than those in low expression group(26.83%,26.83%,34.15%,24.39%),the dfferences were statistically significant(X^(2)=4.785,28.035,7.3118.758,all P<0.05).The proportions of tumor diameter>10 mm,poorly dfferentiated,and lymph node metastasis in HIF-1α high-ex-pression group(62.50%,67.86%,62.50%)were higher than those in low-expression group(18.42%,26.32%,31.58%),the differanec were sfatitinally sionificant(X^(2)=17.79516.1098.658,all P<0.05).During the 2-year follow-up,postoperative recurrence and metastasis occurred in 14 patients in observation group,while no postoperative recurrence or metastasis occurred in 80 patients.The results of Cox univariate analysis showed that high expression of HIF-1α,high expression of LICAM,tumor size,and clinical stage were all factors influencing postoperative recurrence and metastasis in patients with cervical cancer(all P<0.05).Cox multivariate regression model showed that high expression of HIF-1α,high expression of LICAM,and clinical stage(stage II)were influencing factors of postoperative recurrence and metastasis in patients with cervical cancer(all P<0.05).Conclusion In cervical cancer tissues,LICAM and HIF-1α are highly expressed.The expression level of LICAM in cervical cancer tissues is related to clinical stage,lymph node metastasis,vascular metastasis,and degree of differentiation.The expression level of HIF-1α in cervical cancer tissues is related to lymph node metastasis,tumor diameter,and degree of differentiation.The expression levels of LICAM and HIF-1α,as well as the clinical stage,are independent influencing factors of postoperative recurrence and metastasis of cervical cancer.
作者
张继振
林军
ZHANG Ji-zhen;LIN Jun(不详;Department of Pathology,Wenling Traditional Chinese Medicine Hospital,Wenling,Zhejiang 317500,China)
出处
《中国妇幼保健》
2025年第14期2646-2650,共5页
Maternal and Child Health Care of China
基金
浙江省衢州市科技计划项目(2023K138)。
关键词
宫颈癌
L1细胞黏附分子
缺氧诱导因子-1Α
病理特点
预后
Cervical cancer
Ll cell adhesion molecule
Hypoxia-inducible factor-1
Pathological characteristic
Prognosis
