摘要目的：探讨低氧诱导因子-1α（HIF-1α）和生存素（Survivin）在乳腺癌中的表达及意义。方法选择日照市人民医院2009年6月至2014年6月，应用免疫组化Ultra SensitiveTM S-P 法检测的乳腺浸润性导管癌（IDC）128例、乳腺导管原位癌（DCIS）89例、乳腺非典型导管增生（ADH）57例以及乳腺普通导管增生（UDH）60例，分析HIF-1α和Survivin的阳性表达差异及其与临床病理因素的关系。结果 HIF-1α的表达在IDC与DCIS组（χ2=13.442）、ADH组（χ2=22.272）以及UDH组（χ2=52.789）比较，差异有统计学意义，DCIS 与 UDH 组比较（χ2=8.144，P=0.004）差异同样有统计学意义，DCIS与ADH比较差异无统计学意义（χ2=2.188， P=0.139）；Survivin的表达在IDC组（χ2=70.540，P=0.000）、DCIS组（χ2=51.967，P=0.000）、ADH（χ2=42.829，P=0.000）与UDH组相比较，差异有统计学意义（P<0.0083）；IDC与DCIS（χ2=1.330， P=0.249）、IDC与ADH（χ2=1.484，P=0.223）比较，Survivin的表达差异均无统计学意义（P>0.0083）。在乳腺癌中，HIF-1α与Survivin的表达与组织学分级、淋巴结、远处转移及肿瘤分期呈正相关（P<0.05），而与患者年龄、肿瘤大小无关（P>0.05）。HIF-1α和Survivin的表达正相关（P=0.018，95%CI：0.0376～0.3839），但一致性不理想（κ=0.211）。结论 HIF-1α、Survivin高表达与乳腺癌发生、侵袭及转移行为有关，HIF-1α与Survivin联合检测有望作为乳腺癌发生发展、复发转移及预后的指标。

abstractsObjectiveTo study the expression and significance of Hypoxia inducible factor 1α (HIF-1α) and Survivin in breast carcinoma.Methods Immunhistochemical Ultra SensitiveTM S-P method was employed to detect the expression of HIF-1α and Survivin in 128 cases invasive ductal carcinoma (IDC),89 cases of ductal carcinoma in situ (DCIS),57 cases of atypical ductal hyperplasia (ADH),and 60 cases of usual duct hyperplasia lesions (UDH).The multiple biological parameters including the cancer grade and stage were compared with and investigate the associations of HIF-1α and Survivin expressions in breast carcinoma.Results There were significant differences in the positive expression rates of HIF-1α between IDC and DCIS tissue(χ2=13.442),IDC and ADH(χ2=22.272),IDC and UDH(χ2=52.789).The same with DCIS and UDH(χ2=8.144,P=0.004).However,there were no significant differences of HIF-1α expression rates between DCIS and ADH(χ2=2.188,P=0.139).At the same time,There were significant differences(P<0.008 3) in the positive expression rates of Survivin between IDC and UDH(χ2=70.540,P=0.000),DCIS and UDH(χ2=51.967,P=0.000),ADH and UDH(χ2=42.829,P=0.000).There were no significant differences of Survivin expression rates between IDC and DCIS(χ2=1.330,P=0.249),IDC and ADH(χ2=1.484,P=0.223).There was positive correlation in over-expressions of HIF-1α and Survivin with histological grade, lymph node metastasis,distant metastasis and stage of IDC tumor,and the expressions of the two proteins were not related with age and tumor size (P>0.05). There was poor correlation between HIF-1α and Survivin (P=0.018, 95%CI:0.037 6-0.383 9).Conclusion The over-expression of HIF-1αand Survivin might be important biological markers for invasion ,lymph node metastasis and distant metastasis of IDC.The combined detection of HIF-1α and Survivin may be as the predictors of development and recurrence and prognosis of breat carcinoma.