Expression Of HIF-1α And PROX1 In Esophageal Carcinoma And Its Relationship With Radiotherapy Sensitivity

Objective:The purpose of this study is to detect the expression of hypoxia-inducible factor-1α(HIF-1α)and prospero homeobox protein 1(PROX1)in esophageal cancer(squamous cell carcinoma)and their relationship with clinicopathological factors,radiotherapy efficacy and prognosis.Methods:Immunohistochemistry was used to detect the expression of HIF-1α and PROX1 in esophageal squamous cell carcinoma tissue samples,and to analyze the relationship between the expression of the two genes and clinically relevant factors,radiotherapy sensitivity and patient survival,and whether there is any correlation between the expression of HIF-1α and PROX1.Results:The positive expression rates of HIF-1α and PROX1 in esophageal squamous cell carcinoma were 63.5%(40/63)and 61.9%(39/63),respectively.The positive expression of HIF-1α was correlated with the depth of invasion(χ2=6.581,P=0.010),lymph node metastasis(χ2=9.450,P=0.001)and clinical stage(χ2=5.002,P=0.025).The positive expression of PROX1 was correlated with pathological grade(χ2=7.115,P=0.029),the depth of invasion(χ2=5.661,P=0.017)and lymph node metastasis(χ2=6.733,P=0.009),both were not significantly correlated with gender,age,tumor site and lesion length(P>0.05).Positive correlation between HIF-1α and PROX1 in esophageal squamous cell carcinoma(r=0.356,P=0.004).The short-term efficacy of radiotherapy was negatively correlated with the expression of HIF-1α(r=-0.364,P=0.003)and PROX1(r=-0.315,P=0.012),and was correlated with age(χ2=7.906,P=0.015),depth of invasion(χ2=14.316,P=0.001),lymph node metastasis(χ2=6.840,P=0.032),clinical stage(χ2=15.283,P <0.001)and the presence of concurrent chemotherapy(χ2=8.112,P=0.015).Among them,the presence or absence of concurrent chemotherapy may be an independent factor affecting the efficacy of radiotherapy(P=0.026).In terms of survival,PFS(P=0.001,P=0.032)and OS(P<0.001,P=0.006)were significantly reduced in patients with high expression of HIF-1α and PROX1 compared with those with low expression.Cox multivariate regression analysis showed that the depth of invasion(P=0.033)and the positive expression of HIF-1α in tumor tissue(P=0.039)might be independent risk factors affecting the prognosis of patients with esophageal squamous cell carcinoma.Conclusion:HIF-1α and PROX1 proteins were highly expressed in esophageal squamous cell carcinoma tissues and were closely correlated with clinicopathological features,which were negatively correlated with the efficacy of radiotherapy and the survival prognosis of patients.Therefore,HIF-1α and PROX1 may become molecular markers to predict the efficacy and prognosis of radiotherapy in patients with esophageal squamous cell carcinoma.