Perfil da expressão de HIF-1α em células linfoides do infiltrado inflamatório peritumoral e intratumoral como marcador prognóstico do carcinoma epidermoide de cavidade oral

Abstract

The HIF-1 transcriptional complex is responsible for controlling transcription of over 100 genes involved in cell hypoxia response. HIF-1α subunit is stabilized in hypoxia conditions, dimerizes with HIF-1β forming the active HIF-1 transcriptional factor. In inflammatory cells, high HIF-1α expression might induce lymphocytic immunosuppression, decreasing tumoral antigen recognition, allowing tumor growth. The present work aimed to investigate the relationship between HIF-1α expression in lymphocytes inflammatory infiltrate from intratumoral and peritumoral region of 56 patients with oral cancer. Data indicates a prognostic value for this expression. High HIF-1α expression in peritumoral inflammatory cells was significantly related to worse patient outcome, whereas high expression in the intratumoral lymphoid cells correlates with a better prognosis. A risk profile indicating the chance of disease relapse and death was designed based on HIF-1α expression in inflammatory infiltrate cells, defining low, intermediate and high risks. This risk profile was able to determine that high HIF-1α expression in peritumoral lymphocytes correlates with worse prognosis, independently of intratumoral inflammatory infiltrate expression. Low HIF-1α in peritumoral lymphocytes and high expression in the intratumoral lymphocytes was considered a low risk profile, showing no cases of disease relapse and disease related death. Intermediate risk was associated with low HIF-1α expression in inflammatory infiltrate intratumoral and peritumoral. in tumor and tumor margins. These results suggest that HIF-1α expression in tumor and peritumoral inflammatory cells may play an important role as prognostic tumor marker.