| Objective The purpose of this study was to explore the mechanism of HIF-1 alpha, VEGF and NCXl in the occurrence and development of sinonasal squamous cell carcinoma and to provide experimental evidence for early clinical diagnosis, treatment strategies and evaluation of the degree of malignancy.Materials and Methods 1. We collected 50 cases surgical removal of sinonasal squamous cell carcinoma specimens from rhinology department of the first affiliated hospital of zheng zhou university during May 1, 2009 to May 1, 2014, and these specimens were archived integrity. The specimens of pathological results were confirmed by two or more expert diagnosis. All patients were not treated with chemotherapy, radiotherapy and other related antitumor therapy before operation. Another 22 cases of specimens of paraffin blocks from normal inferior turbinate mucosa was collected as control group.2. We analyzed immunohistochemical staining of HIF-1 alpha, VEGF and NCXl protein expression and distribution in SNSCC, and compared the difference of positive expression in the two groups was statistically significant or not. The correlation among the three factors was also analyzed. Finally, the relationship between the three factors and different clinical indicators of sinonasal squamous cell carcinoma was explored. 3. The experimental data were analyzed by using SPSS 17 software. Two groups of independent samples ranked data(expression intensity of three factors in sinonasal squamous cell carcinoma and normal inferior turbinate mucosa) were compared using the Mann Whitney rank sum test, chi-square test was used to compare between the rest of the two independent samples positive rate, when statistical data of two groups did not conform to the inspection requirements, statistical analysis was performed using the Fisher's exact probability test, the difference was statistically significant when P < 0.05. Spearman rank correlation analysis was used to discuss the correlation among HIF-1 alpha ?VEGF and NCXl. When the correlation coefficient r>0,it represents the two factors is positively correlated. When the correlation coefficient r <0, it represents the two factors was negative correlation.We still used P < 0.05 to determine the difference was statistically significant.Results 1.The nucleus is the main positive expression of HIF-1 alpha, which is yellow, brown yellow granular, and the negative expression is blue granule.In SNSCC,the HIF-1 alpha protein positive expression rate was 72%, but in normal inferior turbinate mucosa, the positive rate was 32%, their difference was statistically significant(P<0.05).The expression of HIF-1 alpha in tumor stage III and IV(84.38%) was higher than that in the stage of?and ?(50%), and the difference between them was statistically significant(P<0.05).The expression of lymph node metastasis(80%) group was obviously higher than that of group without lymph node metastasis(37.50%), and the expression differences between the two groups had statistical significance(P < 0.05).In the tissue of SNSCC, the expression HIF- 1 alpha had nothing to do with the onset age, the gender of the patients(P > 0.05). 2.The expression of VEGF is mainly located in cytoplasm, like tan particle shaped;In sinonasal squamous carcinoma tissues, VEGF expression positive rate was 76%, and the positive rate was 18% in normal inferior turbinate mucosa tissue, the difference was statistically significant between them(P < 0.05).VEGF in tumor ?-? period expression(90.63%)was higher than in the expression of tumor ?-? period(55.56%), and the expression differences between them was statistically significant(P < 0.05), the expression of VEGF is associated with the lymph node metastasis of SNSCC patients, in the presence of lymph node metastasis group was higher than that of no lymph node metastasis group(P < 0.05),The expression of VEGF was not correlated with the age of cancer onset and gender of patients(P>0.05). 3.Protein NCXl is mainly expressed in the cell membrane and in SNSCC, NCXl protein positive expression rate was 70%, normal inferior turbinate mucosa, the positive rate was 9%, and that the difference between the two groups had statistical significance(P < 0.05).The expression of NCXl in SNSCC was related to the clinical stage of SNSCC. The expression of in SNSCC stage III-IV(96.88%)was higher than that in tumor I- ?(61.11%), and the difference was statistically significant(P<0.05). The positive expression of NCXl was not related with the lymph node metastasis, age and gender(P>0.05). 4.The correlation of expression of HIF-1 alpha, VEGF, NCXl in SNSCC was tested by Spearman rank correlation test, then we came to the following results: HIF-1 alpha expression was positively correlated with VEGF expression in SNSCC(r=0.453,P<0.05), HIF-1 alpha expression was positively correlated with NCXl expression in SNSCC(r=0.393,P<0.05), and VEGF was positively correlated with NCXl expression in SNSCC(r=0.342,P<0.05).Conclusions 1.The abnormal expression of HIF-1 alpha, VEGF and NCXl may be related with the occurrence and development of sinonasal squamous cell carcinoma. The over expression of HIF-1 alpha and VEGF may also promote the lymph node metastasis of sinonasal squamous cell carcinoma. 2.The expression of HIF-1 alpha, VEGF, NCXl in the sinonasal squamous cell carcinoma had a synergistic effect.The expression of HIF-1 alpha and VEGF, HIF-1 alpha and NCXl, VEGF and NCXl in the sinonasal squamous cell carcinoma were positively correlated. 3.The HIF-1 alpha, NCXl and VEGF can be used as potential molecular markers in the diagnosis of sinonasal squamous cell carcinoma, the degree of expression of the three can be used as an indicator for the early diagnosis and prediction of malignancy in patients with sinonasal squamous cell carcinoma. |
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