王 銘,馮海涼,劉 赫,姜玉新,劉玉琴,朱慶莉,戴 晴,李建初,李康寧
1中國(guó)醫(yī)學(xué)科學(xué)院 北京協(xié)和醫(yī)學(xué)院 北京協(xié)和醫(yī)院超聲診斷科,北京 100730
2中國(guó)醫(yī)學(xué)科學(xué)院 北京協(xié)和醫(yī)學(xué)院 基礎(chǔ)醫(yī)學(xué)研究所細(xì)胞資源中心,北京 100005
?
同種移植小鼠乳腺癌超聲造影增強(qiáng)模式與缺氧誘導(dǎo)因子1α的相關(guān)性
王銘1,馮海涼2,劉赫1,姜玉新1,劉玉琴2,朱慶莉1,戴晴1,李建初1,李康寧1
1中國(guó)醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)學(xué)院北京協(xié)和醫(yī)院超聲診斷科,北京 100730
2中國(guó)醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)學(xué)院基礎(chǔ)醫(yī)學(xué)研究所細(xì)胞資源中心,北京 100005
劉玉琴電話:010- 69156473,電子郵件:liuyuqin@pumc.edu.cn
摘要:目的探討乳腺癌超聲造影(CEUS)增強(qiáng)模式與缺氧誘導(dǎo)因子1α(HIF- 1α)表達(dá)及微血管密度(MVD)的關(guān)系。方法在22只小鼠體內(nèi)建立同種移植性乳腺癌,于接種后第4、6、7、8、9、10、11天隨機(jī)抓取3~4只小鼠進(jìn)行常規(guī)超聲及CEUS檢查,檢查結(jié)束后處死小鼠并使用免疫組織化學(xué)方法檢測(cè)腫瘤標(biāo)本中HIF- 1α表達(dá)及 MVD,分析CEUS增強(qiáng)模式與HIF- 1α表達(dá)及MVD的關(guān)系。結(jié)果22只小鼠乳腺癌中瘤體<0.05 cm3組5例,CEUS表現(xiàn)為Ⅰ型增強(qiáng)模式,周邊環(huán)狀增強(qiáng),內(nèi)部無(wú)增強(qiáng)4例,Ⅱ型增強(qiáng)模式,周邊環(huán)狀增強(qiáng)并向病灶內(nèi)呈點(diǎn)線狀穿入1例;0.05~0.75 cm3組9例,多表現(xiàn)為Ⅲ型增強(qiáng)模式,病灶彌漫性增強(qiáng),均勻/不均勻5例;>0.75 cm3組8例,多表現(xiàn)為Ⅳ型增強(qiáng)模式,周邊環(huán)狀增強(qiáng),內(nèi)部結(jié)節(jié)狀增強(qiáng)7例。3組瘤體在CEUS增強(qiáng)模式上差異有統(tǒng)計(jì)學(xué)意義(P<0.01),Ⅰ~Ⅳ型CEUS增強(qiáng)模式與腫瘤大小相關(guān)(r=0.841,P<0.05)。小鼠乳腺癌中HIF- 1α表達(dá)與增強(qiáng)模式(Ⅰ~Ⅳ型)呈負(fù)相關(guān)(r=-0.596,P=0.003),與腫瘤大小無(wú)相關(guān)性(P>0.05)。Ⅰ~Ⅳ型CEUS增強(qiáng)模式間MVD均值差異無(wú)統(tǒng)計(jì)學(xué)意義,MVD與腫瘤大小無(wú)相關(guān)性(P>0.05)。結(jié)論CEUS可動(dòng)態(tài)評(píng)估同種移植性小鼠乳腺癌的血管生成,腫瘤增強(qiáng)模式與腫瘤HIF- 1α的表達(dá)水平相關(guān)。
關(guān)鍵詞:乳腺癌;同種移植動(dòng)物模型;超聲造影;缺氧誘導(dǎo)因子1α;腫瘤血管生成
Effects of Rapamycin and Rapamycin-loaded Poly(lactic-co-glycolic)Acid Nanoparticles on Apoptosis and Expression of bcl- 2 and p27kip1Proteins of Human Umbilical Arterial Vascular Smooth Muscle Cell Correlation of Contrast-enhanced Ultrasound with Expression of Hypoxia Inducible Factor- 1α in Transplanted Mice Mammary Cancer
ActaAcadMedSin,2015,37(6):656-661
乳腺癌是一種血管依賴性腫瘤,腫瘤生長(zhǎng)至1~2 mm3時(shí)即需新生血管的形成[1]。缺氧誘導(dǎo)因子- 1α(hypoxia inducible factor- 1α,HIF- 1α)是惡性腫瘤細(xì)胞在缺氧條件下產(chǎn)生的具有轉(zhuǎn)錄活性的核蛋白,啟動(dòng)血管內(nèi)皮生長(zhǎng)因子 (vascular endothelial growth factor,VEGF)的表達(dá),與腫瘤血管生成密切相關(guān),并與乳腺癌預(yù)后、療效評(píng)估有關(guān)[2- 4],因此,監(jiān)測(cè)HIF- 1α在實(shí)體腫瘤中的活性在臨床中具有重要價(jià)值[3,5]。超聲造影微血管顯像可實(shí)時(shí)動(dòng)態(tài)顯示活體腫瘤的血流灌注及血流動(dòng)力學(xué)狀態(tài)。本研究借助小鼠乳腺癌移植瘤模型探討超聲造影(contrast-enhanced ultrasound,CEUS)對(duì)乳腺癌新生血管的動(dòng)態(tài)評(píng)估價(jià)值,以及CEUS與HIF- 1α表達(dá)狀態(tài)之間的關(guān)系。
材料和方法
實(shí)驗(yàn)動(dòng)物和材料雌性615系小鼠22只,6周齡,體重16~18 g,購(gòu)自天津血液研究所實(shí)驗(yàn)動(dòng)物中心[合格證號(hào):SCXK(津)2009- 0002]。615系小鼠乳腺癌Ca761瘤株,由國(guó)家實(shí)驗(yàn)細(xì)胞資源共享平臺(tái)中國(guó)醫(yī)學(xué)科學(xué)院基礎(chǔ)醫(yī)學(xué)研究所細(xì)胞資源中心提供??剐∈驢IF- 1α單克隆抗體(ab463)、兔抗小鼠CD34單克隆抗體(ab81289)購(gòu)自Abcam公司。辣根過(guò)氧化物酶標(biāo)記山羊抗小鼠IgG、辣根過(guò)氧化物酶標(biāo)記山羊抗兔IgG購(gòu)自北京中山金橋公司。
同種移植小鼠乳腺癌模型的建立液氮下復(fù)蘇Ca761/L凍存細(xì)胞,細(xì)胞懸液法接種于615系荷瘤種鼠右腋下,2~3周后分離剝?nèi)∧[瘤組織,制作成腫瘤細(xì)胞懸液,接種于615系小鼠左臀部皮下,建立同種移植瘤模型,劑量0.1 ml/只,約含瘤細(xì)胞2×106個(gè)。22只小鼠于種植腫瘤后第4、6、7、8、9、10、11天進(jìn)行超聲檢查。每天挑選3~4只小鼠進(jìn)行實(shí)驗(yàn),麻醉脫毛,暴露左臀部移植瘤,進(jìn)行常規(guī)超聲及CEUS檢查,CEUS結(jié)束后處死小鼠獲取病理標(biāo)本。實(shí)驗(yàn)流程中嚴(yán)格遵循實(shí)驗(yàn)動(dòng)物福利和倫理學(xué)要求。
檢查方法及圖像分析采用Philips IU22超聲診斷儀,L12- 5線陣探頭。乳腺造影設(shè)置,脈沖反相諧波成像技術(shù),機(jī)械指數(shù)調(diào)節(jié)至0.07,造影總增益設(shè)置為70%,深度2.5 cm,單點(diǎn)聚焦置于圖像最深部。造影劑為SonoVue。常規(guī)超聲顯示腫瘤,選取最大切面,調(diào)節(jié)圖像至最佳,切換入超聲造影模式,胰島素針抽取造影劑0.05 ml,采用眶后靜脈團(tuán)注法注入小鼠體內(nèi),保持最大切面不變,連續(xù)實(shí)時(shí)觀察病灶動(dòng)態(tài)灌注過(guò)程3 min。
常規(guī)超聲檢查:于腫瘤最大切面上測(cè)量腫瘤長(zhǎng)徑a及前后徑b,計(jì)算腫瘤體積V=1/2ab2。
超聲造影圖像分析:根據(jù)增強(qiáng)達(dá)峰時(shí)病灶內(nèi)造影劑的分布將增強(qiáng)模式分為4型:Ⅰ型:周邊環(huán)狀增強(qiáng),內(nèi)部無(wú)增強(qiáng);Ⅱ型:周邊環(huán)狀增強(qiáng),并向病灶內(nèi)穿入;Ⅲ型:彌漫性增強(qiáng),均勻或不均勻;Ⅳ型:周邊環(huán)狀增強(qiáng),病灶內(nèi)部結(jié)節(jié)狀增強(qiáng) (圖1)。
HIF- 1α和微血管密度表達(dá)情況的檢測(cè)分離剝?nèi)∧[瘤組織,沿造影檢查切面剖開(kāi)腫瘤,于切面?zhèn)确筚N紙片,將腫瘤組織放于甲醛中固定,石蠟包埋,沿造影切面連續(xù)切片,進(jìn)行HE及免疫組織染色。
結(jié)果判定:(1)以CD34標(biāo)記計(jì)數(shù)微血管密度(microvessel density,MVD):在低倍鏡(×40)下找到腫瘤組織內(nèi)血管密集區(qū),即“熱點(diǎn)”,然后在高倍鏡(×200)下觀察,采用Weidner等[6]評(píng)判標(biāo)準(zhǔn),以5個(gè)高倍鏡視野下毛細(xì)血管和微血管的平均值作為該例的MVD值。(2)HIF- 1α:采用半定量計(jì)分法判定,細(xì)胞核或胞漿內(nèi)出現(xiàn)黃色或棕黃色顆粒為陽(yáng)性細(xì)胞。按陽(yáng)性著色程度評(píng)分,0分無(wú)著色;1分胞漿著色為主;2分:細(xì)胞核弱著色;3分:細(xì)胞核強(qiáng)著色。按陽(yáng)性細(xì)胞所占比例評(píng)分,0分≤5%;1分為6%~25%,2分為26%~50%,3分為51%~75%,4分為>75%。兩者乘積判定陽(yáng)性結(jié)果:0級(jí)(-):0分;1級(jí)(+):1~4分;2級(jí)(++):5~8分;3級(jí)(+++):9~12分。其中2~3級(jí)為高表達(dá),0~1級(jí)為低表達(dá)。
統(tǒng)計(jì)學(xué)處理采用SPSS 17.0軟件進(jìn)行分析。計(jì)量資料以均數(shù)±標(biāo)準(zhǔn)差表示。兩樣本構(gòu)成比及兩變量間關(guān)聯(lián)性采用X2檢驗(yàn)及Fisher精確概率法。相關(guān)性判斷使用相關(guān)性分析。兩樣本均數(shù)比較采用t檢驗(yàn)。P<0.05為差異有統(tǒng)計(jì)學(xué)意義。
結(jié)果
小鼠乳腺癌超聲造影表現(xiàn)建立22只小鼠乳腺癌模型,成瘤率100%。根據(jù)腫瘤大小不同分為3組(<0.05 cm3、0.05~0.75 cm3,>0.75 cm3),經(jīng)Fisher 確切概率法檢驗(yàn),不同瘤體組CEUS表現(xiàn)差異有統(tǒng)計(jì)學(xué)意義(P<0.01),<0.05 cm3瘤體組中Ⅰ型增強(qiáng)模式多見(jiàn),0.05~0.75 cm3瘤體組中Ⅲ型增強(qiáng)模式多見(jiàn),>0.75 cm3瘤體組中Ⅳ型增強(qiáng)模式多見(jiàn)(表1)。Spearman相關(guān)性分析顯示CEUS增強(qiáng)模式(Ⅰ~Ⅳ型)與腫瘤大小呈正相關(guān)(r=0.841,P< 0.05)。
小鼠乳腺癌HIF- 1α表達(dá)與CEUS增強(qiáng)模式的關(guān)系HIF- 1α陽(yáng)性細(xì)胞主要分布于乳腺癌病灶邊緣、腫瘤新生血管周?chē)鷧^(qū)域,以及壞死腫瘤組織周邊。Ⅰ型CEUS增強(qiáng)模式4例,其中HIF- 1α表達(dá)2級(jí)(++)1例、3級(jí)(+++)3例。Ⅱ 型增強(qiáng)模式3例,其中HIF- 1α表達(dá)2級(jí)(++)2例、3級(jí)(+++)1例。Ⅲ 型增強(qiáng)模式6例,其中HIF- 1α表達(dá)0級(jí)(-)1例、1級(jí)(+)2例、2級(jí)(++)1例、3級(jí)(+++)2例。Ⅳ型增強(qiáng)模式9例,其中HIF- 1α表達(dá)0級(jí)(-)2例、1級(jí)(+)3例、2級(jí)(++)4例。經(jīng)Spearman相關(guān)性分析顯示HIF- 1α表達(dá)狀態(tài)(-~+++)與 Ⅰ~Ⅳ型增強(qiáng)模式呈負(fù)相關(guān)(r=-0.596,P=0.003),與腫瘤大小無(wú)相關(guān)性(P>0.05)(圖2、圖3)。
小鼠乳腺癌CD34標(biāo)記MVD值與CEUS增強(qiáng)模式的關(guān)系由于Ⅰ型與Ⅱ型增強(qiáng)模式均以周邊增強(qiáng)為主,僅病灶內(nèi)部血流灌注略有差別,因此將Ⅰ型與Ⅱ型合并統(tǒng)計(jì)。(Ⅰ+Ⅱ)型7例,MVD均值(14.4±3.7)個(gè)/高倍視野(9~19個(gè)/高倍視野);Ⅲ型6例,MVD均值為(14.5±6.09)個(gè)/高倍視野(8~25個(gè)/高倍視野);Ⅳ型9例,MVD均值為(11.0±6.49)個(gè)/高倍視野(5~21個(gè)/高倍視野)。經(jīng)單因素方差分析,不同CEUS增強(qiáng)模式下MVD均值差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。Pearson相關(guān)性分析顯示MVD與腫瘤大小無(wú)關(guān)(P>0.05)(圖2、圖3)。
CEUS:超聲造影
CEUS:contrast-enhanced ultrasound
A. Ⅰ型:周邊環(huán)狀增強(qiáng),內(nèi)部無(wú)增強(qiáng);B. Ⅱ型:周邊環(huán)狀增強(qiáng),并向病灶內(nèi)穿入;C. Ⅲ型:彌漫性增強(qiáng),均勻或不均勻;D. Ⅳ型:周邊環(huán)狀增強(qiáng),病灶內(nèi)部結(jié)節(jié)狀增強(qiáng)
A. type Ⅰ:peripheral ring enhancement with no enhancement within the tumor;B. type Ⅱ:peripheral ring enhancement with deep penetration;C. type Ⅲ:homogeneous or heterogeneous enhancement;D. type Ⅳ:peripheral ring enhancement with focal nodular enhancement within the tumor
圖 1CEUS增強(qiáng)模式分型
Fig 1Classification of contrast-enhanced patterns of ultrasound
表 1 22例小鼠乳腺癌的CEUS表現(xiàn)[n(%)]
經(jīng)Fisher 確切概率法檢驗(yàn),3組瘤體在CEUS增強(qiáng)模式上差異有統(tǒng)計(jì)學(xué)意義(P<0.01)
Contrast-enhanced pattern was significantly different in different volume groups (P<0.01)(Fisher’s test)
HIF- 1α:缺氧誘導(dǎo)因子- 1α;MVD:微血管密度
HIF- 1α:hypoxiainducible factor- 1α;MVD:microvessel density
A. 灰階超聲顯示腫瘤大小1.4 cm×0.7 cm;B. CEUS增強(qiáng)模式表現(xiàn)為Ⅲ型,非均勻性彌漫性增強(qiáng);C.HIF- 1α表達(dá)為1級(jí)(棕褐色細(xì)胞為陽(yáng)性細(xì)胞)(免疫組織化學(xué)染色,×400);D. CD34標(biāo)記的MVD,平均MVD計(jì)數(shù)7個(gè)/高倍視野(×200)
A. the gray-scale ultrasound showed the tumor size was 1.4 cm×0.7 cm;B.the contrast-enhanced pattern presented as type Ⅲ,showing heterogeneous enhancement;C. staining of HIF- 1α presented as grade 1(sepia cell showed the positive cell) (immunohistochemistry,×400);D. the mean value of MVD was 7 at 200× magnification marked with CD34(×200)
圖 2小鼠乳腺癌種植后第8天超聲表現(xiàn)及免疫組織化學(xué)染色
Fig 2Ultrasonography and immunohistochemical staining of mice breast cancer 8 days after implantation
A. 灰階超聲顯示腫瘤大小1.9 cm×1.2 cm;B. CEUS增強(qiáng)模式表現(xiàn)為Ⅳ型,即腫瘤周邊環(huán)狀增強(qiáng),病灶內(nèi)部結(jié)節(jié)狀增強(qiáng);C.HIF- 1α表達(dá)為1級(jí)(棕褐色細(xì)胞為陽(yáng)性細(xì)胞)(免疫組織化學(xué)染色,×400);D. CD34標(biāo)記的MVD,計(jì)數(shù)MVD均值6個(gè)/高倍視野(×200)
A. the gray-scale ultrasound showed the tumor size was 1.9 cm ×1.2 cm;B. the contrast-enhanced pattern presented as type Ⅳ,peripheral ring enhancement with focal nodular enhancement within the tumor;C. staining of HIF- 1α presented as grade 1(sepia cell showed the positive cell) (immunohistochemistry,×400);D. the mean value of MVD was 6 at 200×magnification marked with CD34(×200)
圖 3小鼠乳腺癌腫瘤種植后第11天超聲表現(xiàn)及免疫組織化學(xué)染色
Fig 3Ultrasonography and immunohistochemical staining of mice breast cancer 11 days after implantation
小鼠乳腺癌HIF- 1α表達(dá)與MVD的關(guān)系22例小鼠乳腺癌中14例HIF- 1α呈高表達(dá)(++~+++),其MVD均值為(16.14±4.24)個(gè)/高倍視野;8例HIF- 1α呈低表達(dá)(-~+),MVD均值為(11.13±4.32)個(gè)/高倍視野。經(jīng)t檢驗(yàn)顯示小鼠乳腺癌HIF- 1α高表達(dá)組中MVD 均值大于HIF- 1α低表達(dá)組MVD 均值(t=-2.652,P<0.05)。
討論
腫瘤的生長(zhǎng)、侵襲、轉(zhuǎn)移與新生血管密切相關(guān)[7- 8],MVD計(jì)數(shù)是臨床評(píng)估血管生成的常用方法。彩色多普勒血流顯像能顯示直徑≥200 μm的血管,但不能顯示低流速的血流(<1 mm/s),對(duì)較小乳腺癌的血流顯示欠佳[9]。CEUS可以顯示直徑<4 μm的血管,清晰顯示腫瘤血流灌注,血管的走形、分布,可作為評(píng)估腫瘤血管生成的可靠方法。
本研究利用小鼠移植瘤模型,觀察生長(zhǎng)不同時(shí)間、不同體積腫瘤的CEUS增強(qiáng)模式,總結(jié)出較小腫瘤的4型CEUS增強(qiáng)模式,腫瘤體積較小(<0.05 cm3)時(shí)腫瘤內(nèi)部多呈點(diǎn)線狀增強(qiáng),隨著腫瘤體積的增大,可為整體增強(qiáng)或病灶內(nèi)部結(jié)節(jié)狀增強(qiáng),小鼠乳腺癌I~Ⅳ型CEUS增強(qiáng)模式與腫瘤大小密切相關(guān)(P<0.05)。本研究結(jié)果顯示不同CEUS增強(qiáng)模式下(Ⅰ+Ⅱ、Ⅲ、Ⅳ型)MVD均值差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。目前關(guān)于CEUS增強(qiáng)模式與MVD的報(bào)道較少。分析本研究Ⅰ~Ⅳ型增強(qiáng)模式間MVD差異無(wú)統(tǒng)計(jì)學(xué)意義的原因,可能是由于MVD計(jì)數(shù)僅選擇腫瘤新生血管的熱區(qū),而CEUS評(píng)估整個(gè)瘤體血供情況;各增強(qiáng)類(lèi)型都有周邊增強(qiáng),而周邊往往是MVD計(jì)數(shù)區(qū)域,因此CEUS和MVD觀察部位不同也許是二者未發(fā)現(xiàn)相關(guān)性的一個(gè)原因。
缺氧誘導(dǎo)因子- 1在腫瘤血管生成、能量代謝腫瘤發(fā)展中發(fā)揮重要作用[10- 11]。在低氧條件下,其功能亞基HIF- 1α通過(guò)增加VEGF的轉(zhuǎn)錄活性及增加VEGF mRNA的穩(wěn)定性促使VEGF表達(dá)進(jìn)而調(diào)節(jié)腫瘤血管形成[12],當(dāng)血供增加,腫瘤氧供豐富時(shí),HIF- 1α分解、降低[13]。本研究顯示小鼠乳腺癌HIF- 1α高表達(dá)組MVD值大于低表達(dá)組MVD值(P<0.05)。CEUS增強(qiáng)模式(Ⅰ~Ⅳ型)與HIF- 1α表達(dá)(-~+++)呈負(fù)相關(guān)(r=-0.596,P=0.003)。目前有關(guān)CEUS增強(qiáng)模式與HIF- 1α表達(dá)相關(guān)性的文獻(xiàn)報(bào)道較少,而且對(duì)于HIF- 1α表達(dá)與血流關(guān)系的研究尚存在爭(zhēng)議[14- 16]。Forsberg等[17]在小鼠腫瘤達(dá)到一定大小時(shí)(接種腫瘤2周后)進(jìn)行CEUS,探討CEUS增強(qiáng)面積與血管生成相關(guān)因子表達(dá)的關(guān)系,結(jié)果顯示CEUS增強(qiáng)面積與環(huán)氧合酶- 2(與腫瘤血管生成相關(guān)的因子)表達(dá)染色面積呈負(fù)相關(guān)。Forsberg等[17]認(rèn)為這可能與腫瘤快速生長(zhǎng)階段微血管向周邊移位,以及瘤體內(nèi)血管容積由于腫瘤的增大和間質(zhì)壓力的增加相對(duì)減少有關(guān),也可能與腫瘤內(nèi)血管生成的異質(zhì)性有關(guān)。
綜上,本研究顯示實(shí)時(shí)灰階CEUS可動(dòng)態(tài)、全面評(píng)估腫瘤內(nèi)血管生成情況,在腫瘤生長(zhǎng)過(guò)程中HIF- 1α表達(dá)狀態(tài)變化復(fù)雜,腫瘤CEUS增強(qiáng)模式可能反映乳腺癌內(nèi)HIF- 1α表達(dá)水平,但結(jié)果仍有待于進(jìn)一步研究。
參考文獻(xiàn)
[1]Holmgren L,O’Reilly MS,F(xiàn)olkman J. Dormancy of micrometastases:balanced proliferation and apoptosis in the presence of angiogenesis suppression [J]. Nat Med,1995,1(2):149- 153.
[2]Buckley DL,Van Molle I,Gareiss PC,et al. Targeting the von Hippel-Lindau E3 ubiquitin ligase using small molecules to disrupt the VHL/HIF- 1alpha interaction [J]. J Am Chem Soc,2012,134(10):4465- 4468.
[3]Xiang L,Gilkes DM,Chaturvedi P,et al. Ganetespib blocks HIF- 1 activity and inhibits tumor growth,vascularization,stem cell maintenance,invasion,and metastasis in orthotopic mouse models of triple-negative breast cancer [J]. J Mol Med (Berl),2014,92(2):151- 164.
[4]Harada H,Inoue M,Itasaka S,et al. Corrigendum:cancer cells that survive radiation therapy acquire HIF- 1 activityand translocate toward tumour blood vessels[J]. Nat Commun,2012,3:783.
[5]Tang CM,Yu J. Hypoxia-inducible factor-1 as a therapeutic target in cancer [J]. J Gastroenterol Hepatol,2013,28(3):401- 405.
[6]Weidner N,Carroll PR,F(xiàn)lax J,et al. Tumor angiogenesis correlates with metastasis in invasive prostate carcinoma [J]. Am J Pathol,1993,143(2):401- 409.
[7]Holmgren L,O’Reilly MS,F(xiàn)olkman J. Dormancy of micrometastases:balanced proliferation and apoptosis in the presence of angiogenesis suppression [J]. Nat Med,1995,1(2):149- 153.
[8]O’Reilly MS,Holmgren L,Shing Y. Angiostatin:a novel angiogenesis inhibitor that mediates the suppression of metastases by a Lewis lung carcinoma[J]. Cell,1994,79(2):315- 328.
[9]朱慶莉,游姍姍,孝夢(mèng)甦,等.對(duì)比超聲定位光散射斷層成像與彩色多普勒血流顯像檢測(cè)乳腺癌血供 [J].中國(guó)醫(yī)學(xué)影像技術(shù),2011,27(9):1833- 1837.
[10]Alemayehu M,Dragan M,Pape C,et al. β-arrestin 2 regulates lysophosphatidic acid-induced human breast tumor cell migration and invasion via Rap1 and IQGAP1 [J]. PLoS One,2013,8(2):e56174.
[11]Kallergi G,Markomanolaki H,Giannoukaraki V,et al. Hypoxia-inducible factor- 1alpha and vascular endothelial growth factor expression in circulating tumor cells of breast cancer patients [J]. Breast Cancer Res,2009,11(6):R84.
[12]Chen IY,Gheysens O,Li Z,et al. Noninvasive imaging of hypoxia-inducible factor- 1α gene therapyfor myocardial ischemia [J]. Hum Gene Ther Methods,2013,24(5):279- 288.
[13]Groulx I,Lee S. Oxygen-dependent ubiquitination and degradation of hypoxia-inducible factor requires nuclear-cytoplasmic trafficking of the von Hippel-Lindau tumor suppressor protein [J]. Mol Cell Biol,2002,22(15):5319- 5336.
[14]張玲. 乳腺癌彩色多普勒血流成像與血管生成活性及淋巴結(jié)轉(zhuǎn)移關(guān)系的研究[D].福州:福建醫(yī)科大學(xué),2010.
[15]Nakajima T,Anayama T,Koike T,et al. Endobronchial ultrasound Doppler image features correlate with mRNA expression of HIF- 1α and VEGF-C inpatients with non-small-cell lung cancer[J]. J Thorac Oncol,2012,7(11):1661- 1667.
[16]Liu Y,Veena CK,Morgan JB,et al. Methylalpinumisoflavone inhibits hypoxia-inducible factor- 1 (HIF- 1) activation by simultaneously targeting multiple pathways [J]. J Biol Chem,2009,284(9):5859- 5868.
[17]Forsberg F,Dicker AP,Thakur ML,et al. Comparing contrast-enhanced ultrasound to immunohistochemical markers of angiogenesis in a human melanoma xenograft model:preliminary results [J]. Ultrasound Med Biol,2002,28(4):445- 451.
·論著·
WANG Ming1,F(xiàn)ENG Hai-liang2,LIU He1,JIANG Yu-xin1,LIU Yu-qin2,ZHU Qing-li1,DAI Qing1,LI Jian-chu1,LI Kang-ning1
1Department of Ultrasound,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
2Cell Resource Center,Institute of Basic Medical Science,CAMS and PUMC,Beijing 100005,China
Corresponding author:JIANG Yu-xinTel:010- 69155491,E-mail:jiangyuxinxh@163.com;
LIU Yu-qinTel:010- 69156473,E-mail:liuyuqin@pumc.edu.cn
ABSTRACT:ObjectiveTo investigate the correlation of contrast-enhanced pattern with expression of hypoxia inducible factor- 1α (HIF- 1α) and microvessel density (MVD) in mice breast cancer.MethodsA total of 22 mice were implanted with breast cancer cells (Ca761) subcutanously in the thigh. The tumors were examined with conventional ultrasound and contrast-enhanced ultrasound (CEUS) on days 4,6,7,8,9,10,and 11 after implantation and then sacrificed. Three or four mice were included each time. Expressions of HIF- 1α and MVD in cancer tissues were detected immunohistochemically. Correlation of contrast-enhanced patterns with expression of HIF- 1α and MVD in breast cancer was analyzed.ResultsMice were divided into 3 groups according to the tumor volume:group 1 (volume<0.05 cm3,n=5),group 2 (volume 0.05- 0.75 cm3,n=9),and group 3 (volume>0.75 cm3,n=8). The CEUS pattern was different in different groups:four mice in group 1 presented as type Ⅰ (peripheral ring enhancement with no enhancement within the tumor) and 1 case presented as type Ⅱ (peripheral ring enhancement with deep penetration). Most mice in group 2 presented as type Ⅲ (homogeneous or heterogeneous enhancement in the whole tumor,n=5). In group 3,most mice presented as type Ⅳ (peripheral ring enhancement with focal nodular enhancement within the tumor,n=7). Contrast-enhanced pattern was significantly different in different volume groups (P<0.01). Enhanced pattern (type Ⅰ-Ⅳ) was closely correlated with tumor volume (r=0.841,P<0.05). The expression of HIF- 1α was negatively correlated with enhanced patterns (type Ⅰ-Ⅳ) (r=-0.596,P=0.003),but not with tumor volume (P>0.05). There was no significant difference in MVD values between different enhanced patterns (type Ⅰ- Ⅳ),and there was no correlation between the MVD and tumor volumes (P>0.05). ConclusionCEUS can be used as a noninvasive tool to monitor tumor angiogenesis in tumor and the enhanced patterns may reflect the expression of HIF- 1α inside the tumor.
Key words:breast cancer;allograft animal model;contrast-enhanced ultrasound;hypoxia inducible factor- 1α;tumor angiogenesis
收稿日期:(2015- 04- 16)
DOI:10.3881/j.issn.1000- 503X.2015.06.005
中圖分類(lèi)號(hào):R445.1
文獻(xiàn)標(biāo)志碼:A
文章編號(hào):1000- 503X(2015)06- 0656- 06
通信作者:姜玉新電話:010- 69155491,電子郵件:jiangyuxinxh@163.com;
基金項(xiàng)目:高等學(xué)校博士學(xué)科點(diǎn)專(zhuān)項(xiàng)科研基金(20121106130002)Supported by the Research Fund for the Doctoral Program of Higher Education of China (20121106130002)
中國(guó)醫(yī)學(xué)科學(xué)院學(xué)報(bào)2015年6期