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One-lung ventilation and HIF1alpha expression in lung cancer and pneumothorax
Savvas G Eleftheriadis1, Efthimios Sivridis, Anastasios Koutsopoulos
1Department of Pathology, Democritus University of Thrace, and University General Hospital of Alexandroupolis, Alexandroupolis, Greece.
Background/Aim:
A prospective study was designed to investigate the effects of anesthesia, particularly that of the one-lung ventilation procedure (OLV), on the expression of hypoxia-inducible factor 1alpha (HIF1alpha) in patients with lung carcinomas and pneumothorax.
Materials And Methods:
The immunohistochemical expression of HIF1alpha was studied in formalin-fixed paraffin-embedded tissues from 60 patients who had undergone thoracic surgery for lung cancer (n=48) or pneumothorax (n=12) under OLV general anesthesia.
Results:
There was a significant, and rather unexpected, association of HIF1alpha expression with high body mass index (BMI) (p=0.01) and high body weight (p=0.01) of patients with lung carcinomas, but other anesthesia-related parameters, including analysis of arterial oxygen partial tension and anthropometric factors remained insignificant. With regard to pneumothorax cases, these were immunohistochemically unreactive and, hence, no relationship was noted between HIF1alpha and anesthesia parameters.
Conclusion:
Anesthesia and OLV procedure performed for lung cancer or pneumothorax does not affect the expression of HIF1alpha. However, the significant link between high BMI and HIF1alpha expression noted in patients with lung carcinomas brings forward a possible connection between obesity and hypoxia-related molecular pathways.
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