| Objective1. To investigate the expressions of the hypoxia-inducible factor-1α(HIF-1α), microvessel density (MVD) in advanced cervical squamous cellcarcinoma and their correlation.2. To explore the changes of HIF-1α and MVD in CSCC by the uterinearterial chemotherapy and embolization and combined with the interventionsclinical effect analyse the significance of the changes.MethodsCollected49patients with CSCC admitted in Jinan Military General Hospitalgynecological department from January2002to September2011, including theFIGO stage Ⅱa12cases, stage Ⅱ b19cases, stage Ⅲa18cases. All thepatients were definitely diagnosed by cervical biopsy, were not given anyanticancer treatment before admission, after enroll in our hospital were giventhe uterine arterial chemotherapy and embolization once.3weeks later after theintervention we assessed the clinical efficacy in line with WHO Solid Tumorscriteria,41cases of them received the surgery opportunity were taken radicalhysterectomy, and the remaining8patients were given second interventionaltreatment, including5cases were taken radical hysterectomy and3cases weretaken radiotherapy treatment. Becase the illness cases who recieved secondinterventional therapy are few, so the efficacy of second interventional therapyand their tissue were not bring into the study.The41patients who were taken radical hysterectomy as experimentalstudy objects, collected the paraffin block of cervical biopsy tissue and after surgical of cervical tumor tissue, respectively marked the group of beforeintervention and after intervention. Collected another12cases at the sameperiod, confirmed with normal cervical tissue by pathological examination as anegative control, marked as the group of normal cervix. Detect the expression ofHIF-1α, MVD (marked by CD105) in the cervical specimens we collected beforeby the methods of immunohistochemical detection.Results1. Clinical effect analysis results:3weeks later,85.71%of the49patientswith CSCC received clinical stage decline. According to the WHO solid tumortreatment efficacy criteria assess the intervention efficacy, the interventionalchemotherapy effective rate is75.51%, each clinical stage effective rate for:stage Ⅱa of83.33%, stage Ⅱb of78.95%, stage Ⅲa of66.67%. This resultshow that as the clinical stage increased, interventional chemotherapy forclinical treatment efficacy of gradually declining (P<0.05).2. Immunohistochemical experiment results:(1) The expression of HIF-1α: The expression of HIF-1α in the group beforeintervention of CSCC were higher than the group of normal cervix (P<0.01). InCSCC, with the increase of pathology classification, the expressions of HIF-1αwere enhanced (P<0.05). The specimens in group of lymph node metastasisexpressed HIF-1α were higher than the groups without lymph node metastasis(P<0.05).The expression of HIF-1α were not related with both age and FIGOstage (P>0.05).(2) The expression of MVD: The expression of MVD in the group beforeintervention of CSCC were higher than the group of normal cervix (P<0.01). InCSCC, with the increase of pathology classification, the expressions of MVDwere significantly enhanced (P<0.01). The specimens in group of lymph nodemetastasis expressed MVD were greatly higher than the groups without lymphnode metastasis (P<0.05). With the increase of FIGO stage, the expressions ofMVD were slowly enhanced, but the difference was not statistically significant(P>0.05). The expression of HIF-1α were not related with the age (P>0.05).(3) The correlation of HIF-1α and MVD expression: In CSCC beforeintervention, the expression of HIF-1α and MVD were positively correlated (P<0.01).(4) The influence of intervention chemotherapy on HIF-1α, MVD expression:The HIF-1α, MVD expression in CSCC before intervention were significantlyhigher than the group after intervention (P<0.01). The HIF-1α, MVD expressionin the group after intervention was negatively correlated with the clinical efficacy(P<0.05).ConclusionsHIF-1α, MVD were highly expressed in CSCC, the higher with malignantdegree, the stronger in the of HIF-1α and MVD. The expression of HIF-1α inCSCC is closely related with MVD. HIF-1α play an important part by boostingtumor angiogenesis in CSCC invasion and metastasis process. The interventionchemotherapy could reduce HIF-1α and MVD expression significantly, theirexpression were negatively related with interventional effect. Detect the HIF-1αand MVD expression around the intervention chemotherapy have a guidingsense in CSCC for the sensitivity of interventional chemotherapy and theevaluation for clinical treatment efficacy. |
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