喉鳞状细胞癌中HIF-1α-VEGF-GLUT1缺氧轴的分子基础及生物标志物潜力

文献信息

中文摘要

在喉鳞状细胞癌中，缺氧在生长、扩散和治疗抵抗中起主要作用。HIF-1α、VEGF和GLUT1是三个相互关联的生物标志物，反映了该反应的不同方面。低氧可被HIF-1α感知，随后它激活有助于肿瘤细胞存活的基因。VEGF有助于形成新血管，而GLUT1增加葡萄糖摄取并在缺氧时维持能量产生。组织和血清研究报告，这些生物标志物在恶性样本中高于良性或正常样本，并与不良临床病理特征相关。然而，其诊断和预后效用仍处于探索阶段，因为临床验证的阈值、诊断性能指标和独立前瞻性验证仍然有限。这些生物标志物的联合评估可能提供关于缺氧信号、血管生成和代谢适应的补充信息，尽管其诊断或预后优于单个生物标志物尚未得到证实。然而，血清测量可能受到分析前和全身因素的影响。因此，为了使这些生物标志物足够先进以用于临床喉科学，需要大型多中心研究和一套标准化的检测方法。

英文摘要

In laryngeal squamous cell carcinoma, hypoxia plays a major role in growth, spread, and treatment resistance. HIF-1α, VEGF, and GLUT1 are three linked biomarkers that show different aspects of this response. Low oxygen can be sensed by HIF-1α, and it follows up by activating genes that help with the survival of the tumour cells. VEGF helps to form new blood vessels, while GLUT1 increases the uptake of glucose and maintains the production of energy even when there is a lack of oxygen. Tissue and serum studies have reported higher levels of these biomarkers in malignant than in benign or normal samples, together with associations with adverse clinicopathological features. However, their diagnostic and prognostic utility remains exploratory because clinically validated thresholds, diagnostic performance measures, and independent prospective validation remain limited. Combined assessment of these biomarkers may provide complementary information on hypoxic signalling, angiogenesis and metabolic adaptation, although its diagnostic or prognostic superiority over individual biomarkers has not yet been established. However, serum measurements can be influenced by pre-analytical and systemic factors. So, in order for these biomarkers to advance enough to be used in clinical laryngology, large multicenter studies and a standardized set of testing methods will be necessary.