The Expression And Clinical Research Of HIF-1α、Glut-1、VEGF In Keratoacanthoma And Cutaneous Squamous Cell Carcinoma

Objective:Keratoacanthoma(KA), originating from hyperplasia ofprickle cell,used to appear in hair follicle of exposure part,with rapid growthand spontaneous resolution characteristics. It is mostly manifested clinically bybenign epithelial hyperplasia, and hematogenous metastasis appears in only afew patients. Due to the similarities of KA to Cutaneous squamous cellcarcinoma(SCC) clinically and histopathologically,these two diseases areinclined to be confused,resulting in misdiagnosis. That whether KA and SCCare two different diseases or KA is one subtype of SCC is still a controversy. Inthis study, we employed immunohistochemistry (IHC,EliVisionTMplustwo-step method) to investigate the expression and correlation ofHIF-1α,GLUT-1and VEGF in KA,SCC and normal skin in order to find thesignificance for differential diagnosis of KA and SCC.Methods:32cases of KA patients and36cases of SCC patientswere selected in our out-patient department and in-patient department,withnormal skin tissues as control.All the tissues were confirmed by HE staining.Samples above were divided into three groups: KA Group, SCC Group andnormal skin Group. The expression and level of HIF-1α、GLUT-1and VEGF intissues were measured by immunohistochemistry.Statistical analyses were performed using SPSS (version17.0). The differences and correlations ofHIF-1α,GLUT-1and VEGF among the groups were analyzed with analysis ofvariance and Pearson correlation analysis.Results:1.The expression of HIF-1α in groups: Nucleus was positive stained inimmunohistochemistry of HIF-1α.The positive expression rates of SCC Group,KA Group and normal skin Group were80.56%、78.13%and12.50%respectively. HIF-1alpha in high, poorly differentiated SCC positive expressionrate were71.4%and93.3%, respectively, and the difference was significant (P<0.05); The positive expression rate of HIF-1α in SCC group was significantlyhigher than that in normal skin group(P＜0.05);the rate in KA group wassignificantly higher than that in normal skin group(P＜0.05);rates in KA groupand SCC group have no significant difference（P＞0.05）;the rates of HIF-1α innormal skin Group, KA Group and SCC Group were increasing gradually.2.The expression of GLUT-1in groups: Nucleus was positive stained inimmunohistochemistry of GLUT-1. Positive rates of SCC Group, KA Groupand normal skin Group were66.67%、56.25%and9.40%respectively. GLUT-1,poorly differentiated SCC positive expression rate were52.4%and86.7%,respectively, and the difference was significant(P<0.05);The positive expressionrate of GLUT-1in SCC group was significantly higher than that in normal skingroup(P＜0.05);the rate in KA group was significantly higher than that innormal skin group(P＜0.05); rates in KA group and SCC group have no significant difference（P＞0.05）; rates of GLUT-1in normal skin Group,KA Group and SCC Group were increasing gradually.3.The expression of VEGF in groups:VEGF immunohistochemicalpositive staining is located in the cell membrane and cytoplasm. Positive ratesof SCC Group, KA Group and normal skin Group were83.33%、37.50%and6.30%respectively. VEGF, poorly differentiated SCC positive expression ratewere76.2%and93.3%, respectively, and the difference was significant(P<0.05);The positive expression rate of VEGF in SCC group was significantlyhigher than that in normal skin group(P＜0.05); the rate in KA group wassignificantly higher than that in normal skin group(P＜0.05);the rate in SCCwas significantly higher than that in KA group （P＜0.05）; rates of VEGF innormal skin Group, KA Group and SCC Group were increasing gradually.Conclusion:1.We found out that specific and high expression of HIF-1α andGLUT-1between keratoacanthoma and Cutaneous squamous cell carcinomahas no statistical difference.This suggested that keratoacanthoma andCutaneous squamous cell carcinoma may have similar cellular metaboliccharacteristics.2.Compared with no expression or low expression of VEGF inkeratoacanthoma,the expression of VEGF in Cutaneous squamous cellcarcinoma is high.The positive rate of VEGF in SCC group is significantlyhigher than that in KA group.This suggested that invasion and metastasis of tumor biology behavior in keratoacanthoma and Cutaneous squamous cellcarcinoma have some differences.3.HIF-1α, GLUT-1, VEGF expression in SCC intensity and degree oftumor differentiation, the lower the degree of differentiation, the higher thedegree of malignancy, the higher the expression.4.HIF-1α, GLUT-1, VEGF expression in KA groups and SCC group, thegrowth process with the KA rapid growth, natural healing, energy metabolismwas significantly higher biological behavior.