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目的探讨血管生成相关因子:癌基因HER2、缺氧诱导因子(HIF)和血管内皮细胞生长因子(VEGF)在乳腺癌组织中的表达及其与血行转移的相关性。方法应用免疫组织化学技术(SP法)检测51例乳腺浸润性导管癌组织中HER2、HIF-1α、VEGF蛋白的表达并随访其术后5年内远处血行转移的情况。结果51例乳腺浸润性导管癌组织中HER2、HIF-1a和VEGF表达均彼此相关。单因素分析显示44例乳腺浸润性导管癌中HER2、VEGF、淋巴结转移和临床肿瘤分期与癌的远处血行转移相关,HIF-1α表达与远处血行转移不相关(P>0.05)。23例淋巴结阴性乳腺癌中,仅VEGF表达与其远处血行转移密切相关(P<0.05)。结论乳腺浸润性导管癌组织中HER2可能通过HIF-1α途径调节VEGF蛋白的表达,参与乳腺癌血管的生成。VEGF表达可作为术后预测血行转移的指标之一,HER2过度表达和HIF-1α表达不能预测远处血行转移。
Objective To investigate the expressions of oncogenes HER2, hypoxia-inducible factor (HIF) and vascular endothelial growth factor (VEGF) in breast cancer and their correlation with hematogenous metastasis. Methods The expressions of HER2, HIF-1α and VEGF in 51 cases of invasive ductal carcinoma of the breast were detected by immunohistochemistry (SP method) and their distant metastasis was observed within 5 years after operation. Results The expressions of HER2, HIF-1a and VEGF in 51 cases of breast invasive ductal carcinoma were correlated with each other. Univariate analysis showed that HER2, VEGF, lymph node metastasis and clinical stage in 44 cases of invasive ductal carcinoma of the breast were associated with distant metastasis of cancer. The expression of HIF-1α was not correlated with distant hematogenous metastasis (P> 0.05). Among 23 cases of lymph node-negative breast cancer, the expression of VEGF alone was closely related to distant metastasis (P <0.05). Conclusion HER2 may regulate the expression of VEGF protein by HIF-1α pathway in breast invasive ductal carcinoma and participate in the generation of breast cancer blood vessels. VEGF expression can be used as an indicator of hematogenous metastasis after surgery. HER2 overexpression and HIF-1α expression do not predict distant hematogenous metastasis.