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本文旨在探讨血管生成拟态(vasculogenic mimicry,VM)与细菌L型(L-form)感染、低氧诱导因子-1α(hypoxia inducible factor 1α,HIF-1α)及MMP-9(matrix metalloproteinase-9)在人卵巢上皮性癌(epithelial ovarian cancer,EOC)组织中表达的关系及功能意义。收集87例EOC术后标本和20例卵巢良性上皮性肿瘤标本,应用免疫组化法、组织化学及革兰染色法检测EOC和卵巢良性上皮性肿瘤组织中VM、HIF-1α、MMP-9的表达及细菌L型的感染情况。结果显示,在EOC和卵巢良性上皮性肿瘤组织中,HIF-1α和MMP-9的阳性表达率分别为52.9%、66.7%和10.0%、10.0%;细菌L型的感染率分别为24.1%和0,差异均有统计学意义(P<0.01);细菌L型的感染与EOC的临床FIGO分期、腹腔种植及淋巴结转移有关(P<0.01或0.05),HIF-1α、MMP-9的表达与EOC的组织学分级、腹腔种植、淋巴结转移以及FIGO分期有关(P<0.01);HIF-1α的表达分别与VM的形成及MMP-9的表达呈正相关(r值分别为0.585和0.505,均P<0.01),同时,MMP-9的表达与VM的形成亦呈正相关(r=0.625,P<0.01)。Kaplan-Meier生存分析表明,VM、HIF-1α及MMP-9的过表达均与患者的生存率有关,阳性表达的患者生存率明显低于阴性者(P<0.05);有细菌L型感染的EOC患者生存率亦明显低于未感染者(P<0.05)。多因素分析表明FIGO分期、VM、HIF-1α及MMP-9的表达是影响EOC根治术后患者预后的独立因素(P<0.05)。以上结果提示,EOC组织中细菌L型感染、HIF-1α和MMP-9的过表达以及VM的形成与肿瘤的分化程度、转移和预后等因素均有关,这些指标的联合检测可能对EOC的进展及预后判断有着重要意义。
This article aims to investigate the relationship between vasculogenic mimicry (VM) and bacterial L-form infection, hypoxia inducible factor 1α (HIF-1α) and matrix metalloproteinase-9 In epithelial ovarian cancer (EOC) tissues and its clinical significance. 87 specimens of EOC and 20 specimens of ovarian benign epithelial tumor were collected. Immunohistochemistry, histochemistry and Gram staining were used to detect the expression of VM, HIF-1α and MMP-9 in EOC and ovarian benign epithelial tumor Expression and bacterial L-type infection. The results showed that the positive expression rates of HIF-1α and MMP-9 in EOC and ovarian benign epithelial tumor tissues were 52.9%, 66.7% and 10.0%, 10.0% respectively; the infection rates of bacterial L type were 24.1% and (P <0.01 or 0.05). The expression of HIF-1α and MMP-9 was significantly correlated with the clinical stage of EOC (FIGO stage, peritoneal implantation and lymph node metastasis) (P <0.01). The expression of HIF-1α was positively correlated with the formation of VM and the expression of MMP-9 (r values were 0.585 and 0.505, respectively, P <0.01). Meanwhile, there was a positive correlation between the expression of MMP-9 and the formation of VM (r = 0.625, P <0.01). Kaplan-Meier survival analysis showed that the overexpression of VM, HIF-1α and MMP-9 were related to the survival rate of patients, the survival rate of patients with positive expression was significantly lower than that of negative (P <0.05) The survival rate of patients with EOC was also significantly lower than those without infection (P <0.05). Multivariate analysis showed that FIGO staging, VM, HIF-1α and MMP-9 expression were independent prognostic factors in patients with EOC (P <0.05). The above results suggest that bacterial L-type infection, HIF-1α and MMP-9 overexpression and VM formation in EOC tissues are related to tumor differentiation, metastasis and prognosis, and the joint detection of these indicators may have influence on the progress of EOC And prognosis is of great significance.