Expression of hypoxia-related markers in inflammatory myofibroblastic tumors of the head and neck
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RESEARCH
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
Expression of hypoxia-related markers in inflammatory myofibroblastic tumors of the head and neck Kui-Rong Wang1, Tao Jiang2,3, Ting-Ting Wu2, Shui-Hong Zhou2*, Hong-Tian Yao4, Qin-Ying Wang2 and Zhong-Jie Lu5
Abstract Background: The etiology of inflammatory myofibroblastic tumors (IMTs) is controversial and the prognosis is unpredictable. Previous studies have not investigated the expression of hypoxia-related markers in IMTs. Methods: Between 2002 and 2012, 12 consecutive patients with histologically proven IMTs were enrolled in the study. Immunohistochemistry was used to detect GLUT-1, HIF-1α, PI3K, and p-Akt expression in paraffin-embedded tumor specimens. Associations among GLUT-1, HIF-1α, PI3K, and p-Akt protein expression and clinical parameters were investigated. Results: The mean duration of follow-up was 52.1 months (range, 11 to 132 months). Six patients had local recurrence. GLUT-1, HIF-1α, PI3K, and p-Akt expression were detected in 41.7%, 50.0%, 33.3%, and 41.7% of patients, respectively. Fisher’s exact test revealed significant correlations between recurrence of IMT and PI3K expression (P = 0.01) and p-Akt expression (P = 0.015). Univariate analyses revealed significant correlations between survival and GLUT-1 expression (P = 0.028), PI3K expression (P = 0.006), and p-Akt expression (P = 0.028). Multivariate analysis did not show a significant relationship between survival and GLUT-1, HIF-1α, PI3K, or p-Akt. Spearman rank correlation analysis showed significant correlations between HIF-1α and PI3K expression (r = 0.707, P = 0.01) and between p-Akt and PI3K expression (r = 0.837, P = 0.001). Conclusions: Although our results are inconclusive owing to the small sample size, they suggest that PI3K and p-Akt expression may play a role in the recurrence of IMTs of the head and neck. Keywords: Glucose transporter-1, Hypoxia-inducible factor 1α, Inflammatory myofibroblastic tumor, PI3K/Akt pathway, Prognosis, Recurrence
Background Inflammatory myofibroblastic tumor (IMT) is an intermediatedgrade tumor, according to the World Health Organizationclassification, and has a potential for recurrence and rare metastasis [1]. However, the etiology of IMT is controversial, and its prognosis is unpredictable [2]. Previous studies, including ours, have shown that the biological behavior of the lesion is associated with location, cellar atypia, the presence of ganglion-like cells, p53, DNA aneuploidy, and anaplastic lymphoma kinase (ALK) [3,4]. However, evidence * Correspondence: [email protected] 2 Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China Full list of author information is available at the end of the article
that these factors are prognostic markers is inconclusive. A number of studies have found high 18 F-2-fluoro-2-deoxyD-glucose (18 F-FDG) uptake in IMTs [5,6]. Increased uptake of FDG, a glucose analog, directly reflects a high glucose metabolic rate in IMTs. Severa
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