作者：岳成，石文健，刘永亮，李景武，张于，董桂兰，张欢，董伟

单位：

1.063000 河北省唐山市人民医院神经外科 2.063000 河北省唐山市人民医院肿瘤外科 3.063000 河北省唐山市人民医院重症医学科 4.063000 河北省唐山市人民医院肿瘤内科 通信作者：董伟，E-mail：polly0522@yeah.net

Units：

1.Department of Neurosurgery, Tangshan People's Hospital, Tangshan 063000, China 2.Department of Tumor Surgery, Tangshan People's Hospital, Tangshan 063000, China 3.Department of Intensive Care Medicine, Tangshan People's Hospital, Tangshan 063000, China 4.Department of Oncology, Tangshan People's Hospital, Tangshan 063000, China Corresponding author: DONG Wei, E-mail: polly0522@yeah.net

关键词：

功能性垂体腺瘤; 侵袭性; 低氧诱导因子1α; 血管内皮生长因子A; 表皮生长因子受体;

Keywords：

Functional pituitary tumor; Invasive; HIF-1α; Vascular endothelial growth factor A; Epidermal growthfactor receptor

CLC：

DOI：

10.12114/j.issn.1008-5971.2021.00.284

Funds：

河北省自然科学基金资助项目（H2020105017）

摘要：

背景研究表明,垂体肿瘤患者低氧诱导因子1α（HIF-1α）表达增加,且HIF-1α表达与肿瘤侵袭性密切相关,但具体调控机制尚需要进一步探讨。目的分析侵袭性功能性垂体腺瘤患者HIF-1α诱导血管生成相关基因的表达及临床意义。方法选取2016年1月至2020年9月唐山市人民医院神经外科门诊收入院并接受手术治疗的功能性垂体腺瘤患者58例,根据Hardy-Wilson分级和Knosp分类方法将其分为侵袭性组（n=28）和无侵袭性组（n=30）。比较两组患者临床资料,HIF-1α、血管内皮生长因子A（VEGF-A）、表皮生长因子受体（EGFR）、CD31、Ki-67表达情况及免疫组化评分。结果侵袭性组患者有视野缺损、肿瘤体积≥6.92 cm3、全切及次全切者所占比例及肿瘤复发率高于无侵袭性组（P <0.05）。侵袭性组患者中HIF-1α、VEGF-A、EGFR、CD31、Ki-67高表达者所占比例高于无侵袭性组（P <0.05）。侵袭性组患者HIF-1α、EGFR、VEGF-A、CD31、Ki-67免疫组化评分高于无侵袭性组（P <0.05）。结论侵袭性功能性垂体腺瘤患者HIF-1α、VEGF-A、EGFR呈高表达,其机制可能为低氧环境下HIF-1α表达增加后上调VEGF-A、EGFR表达,从而促进血管生成,增加肿瘤侵袭性。

Abstract：

【Abstract】 Background Studies have shown that, the expression of hypoxia inducible factor 1 alpha (HIF-1α)in patients with pituitary tumors increased, and HIF-1αexpression is closely related to tumor invasiveness, but the specificregulatory mechanism needs to be further explored. Objective To analyze the expression and clinical significance of HIF-1α induced angiogenesis related genes in invasive functional pituitary adenoma.Methods From January 2016 to September2020, 58 patients with functional pituitary adenoma who were admitted to the Department of Neurosurgery Clinic of TangshanPeople's Hospital and received surgical treatment were selected and divided into invasive group (n=28) and non-invasivegroup (n=30) according to Hardy-Wilson classification and Knosp classification. The clinical information, the expression andimmunohistochemical scores of HIF-1α, vascular endothelial growth factor A (VEGF-A) , epidermal growth factor receptor(EGFR) , CD31 and Ki-67 were compared between the two groups. Results The proportion of patients with visual field defect,tumor volume ≥ 6.92 cm3 , total resection and subtotal resection and tumor recurrence rate in the invasive group were higher thanthose in the non-invasive group (P< 0.05) . The proportion of high expression of HIF-1α, VEGF-A, EGFR, CD31 and Ki-67 in the invasive group were higher than those in the non-invasive group (P< 0.05) . The immunohistochemical scores of HIF-1α, VEGF-A, EGFR, CD31 and Ki-67 in the invasive group were higher than those in the non-invasive group (P< 0.05) .ConclusionHIF-1α, VEGF-A, EGFR in patients with invasive functional pituitary adenoma are highly expressed, and themechanism may be that the expression of VEGF-A and EGFR is up-regulated by the increase of HIF-1α expression in hypoxicenvironment, so as to promote angiogenesis and increase tumor invasiveness.

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