Comparison of Hypoxia-inducible Factor-1α Expression before and after Transcatheter Arterial Embolization in Rabbit VX2 Liver Tumors

Abstract

Purpose Hypoxia-inducible factor-1 alpha (HIF-1 α) expression has been linked with increased mortality and treatment failure in various cancers. The purpose of this study was to test the hypothesis that transcatheter arterial embolization (TAE) induces expression of HIF-1 α within the same rabbit VX2 liver tumor. Materials and Methods Seven VX2 tumors were grown in the livers of 5 New Zealand white rabbits. Ultrasound guided biopsies were taken before and 10 min after TAE from all tumors. Pre- and post- TAE tumor biopsy specimens along with post- TAE whole liver tumor sections were stained with HIF-1 α antibody and analyzed for percentage of HIF-1 α positive nuclei using a spectral unmixing system mounted on a high powered microscope. Statistical data comparisons were performed using Wilcoxon signed-rank test (alpha=0.05). Results TAE of liver tumors resulted in a statistically significant increase in the mean percentage of HIF-1 α expression. The mean percentage of HIF-1 α positive stained nuclei increased from 23 % ± 3.5% in pre- TAE biopsy specimens to 41% ± 8.7% (p< 0.02) in post- TAE biopsy specimens. The increase was even more significant when mean percentage of HIF-1 α positive stained nuclei from the same pre- TAE biopsy specimens were compared to sections from post- TAE whole tumor specimens [60% ± 8.9% (p<0.02)]. Conclusions The study revealed that hypoxia caused by TAE of VX2 liver tumors activates HIF-1 α, a transcription factor that in turn regulates other pro-angiogenic factors.

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