摘要目的：比较低氧诱导因子-1α（HIF-1α）和轴突导向因子4D（Sema4D）在结直肠癌组织和正常组织中的表达，探讨两者之间的相关性及临床意义。方法采用免疫组织化学SP法检测86例结直肠癌组织和52例正常组织中HIF-1α和Sema4D的表达，并分析其与结直肠癌临床病理特征及预后的关系。结果结直肠癌组织中HIF-1α和Sema4D蛋白阳性表达率显著高于正常组织[分别为58.1%（50/86）比7.7%（4/52），χ2=34.624，P<0.01；60.5%（52/86）比11.5%（6/52），χ2=31.839， P<0.01]。 HIF-1α和Sema4D蛋白与结直肠癌组织分化程度（P=0.003，P=0.010）、TNM分期（P=0.003， P=0.017）和淋巴结转移（P=0.003，P=0.020）明显有关；且两者表达呈正相关（r=0.567，P<0.01）。全组患者5年生存率为37%，其中HIF-1α蛋白阳性和阴性表达者的5年生存率分别为24%和56%（P=0.003）；Sema4D蛋白阳性和阴性表达者的5年生存率分别为23%和59%（P=0.001）。 Cox多因素分析显示，Sema4D表达是结直肠癌患者的独立预后因素（P=0.026），而HIF-1α表达不是其独立预后因素（P=0.501）。结论 HIF-1α和Sema4D具有协同关系，两者蛋白的联合检测，可为预测结直肠癌的预后判断提供参考。

abstractsObjective To compare the expressions of hypoxia-inducible factor 1 alpha (HIF-1α) and Semaphorin 4D (Sema4D) in colorectal carcinoma and normal colorectal tissues, and to investigate their correlation and clinical significance. Methods The expressions of HIF-1α and Sema4D were examined in 86 cases of colorectal carcinoma and 52 normal colorectal tissues by SP immunohistochemical staining. Correlation between these two expressions and association of the expressions with clinicopathological characters and prognosis were analyzed. Results The positive rates of HIF-1α and Sema4D protein in colorectal carcinoma tissues were significantly higher than those in normal colorectal tissues (58.1% vs. 7.7%, χ2=34.624,P<0.01; 60.5% vs. 11.5%, χ2=31.839, P<0.01). HIF-1α and Sema4D protein expressions were closely associated with colorectal carcinoma histological types (P=0.003,P=0.010), TNM staging (P=0.003,P=0.017) and lymphatic metastasis (P=0.003,P=0.020), and a significant correlation was observed between the expressions of HIF-1α and Sema4D protein (r=0.567, P<0.01). The 5-year overall survival rate was 37%. Univariate analysis showed that 5-year survival rates of patients with positive and negative HIF-1α protein expression were 24% and 56%(P=0.003), and those with positive and negative Sema4D protein expression were 23% and 59%(P=0.001). Multivariate Cox analysis showed that expression of Sema4D was an independent prognostic factor of colorectal cancer patients(P=0.026), while expression of HIF-1α was not(P=0.501). Conclusion Combined detection of HIF-1α and Sema4D has the potential to predict the development trend of colorectal carcinoma and&nbsp;prognosis of patients.