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目的探讨胰岛素样生长因子I(Insulin-like growth factor I,IGF-I)和IGF-I受体(IGF-IR)在结肠癌中的表达及其与临床病理因素和预后的相关性。方法利用逆转录聚合酶链反应(RT-PCR)方法对收集的114例结肠癌组织、136例结肠腺瘤组织和58例正常结肠组织中IGF-I及IGF-IR mRNA的表达情况进行分析,免疫组织化学法检测其蛋白表达情况。分析IGF-I及IGF-IR的表达与临床病理因素的关系。结果结肠癌组织中的IGF-I和IGF-IR的mRNA表达均高于结肠腺瘤组织、正常结肠组织,差异均有统计学意义(P均<0.05)。单因素分析显示,IGF-I和IGF-IR mRNA表达情况与结肠癌的分化程度、浸润深度及Dukes分期明显相关,差异有统计学意义(P均<0.05)。结肠癌组织IGF-IR蛋白的阳性表达率(70.2%)显著高于正常结肠组织(10.3%)(P<0.01)及结肠腺瘤组织(44.9%)(P<0.05)。结肠癌组织IGF-I蛋白的阳性表达率(62.3%)显著高于正常结肠组织(5.2%)(P<0.01)与结肠腺瘤组织(41.9%)(P<0.05)。单因素分析显示,IGF-IR的蛋白表达与Dukes分期、肿瘤分化程度、肿瘤大体类型有关(P<0.05,P<0.01);IGF-I的蛋白表达与Dukes分期、肿瘤分化程度有关(P<0.05,P<0.01)。多因素Cox回归分析结果显示,癌组织分化程度、Dukes分期、IGF-I和IGF-IR蛋白表达是影响结肠癌患者预后的独立因素(P<0.05,P<0.01)。结论 IGF-I及IGF-IR参与结肠癌的发生发展,同时可以作为预后因子,有助于判断结肠癌生物学行为和评价预后。
Objective To investigate the expression of Insulin-like growth factor I (IGF-I) and IGF-I receptor (IGF-I) in colon cancer and their relationship with clinicopathological factors and prognosis. Methods The expression of IGF-I and IGF-IR mRNA in 114 colon cancer tissues, 136 colon adenoma tissues and 58 normal colon tissues were analyzed by reverse transcriptase-polymerase chain reaction (RT-PCR) Immunohistochemistry was used to detect the protein expression. The relationship between IGF-I and IGF-IR expression and clinicopathological factors was analyzed. Results The mRNA expressions of IGF-I and IGF-IR in colon cancer tissues were significantly higher than those in colon adenomas and normal colon tissues (all P <0.05). Univariate analysis showed that the expression of IGF-I and IGF-IR mRNA was significantly correlated with the degree of differentiation, depth of invasion and Dukes stage in colon cancer (P <0.05). The positive expression rate of IGF-IR protein (70.2%) in colon cancer tissues was significantly higher than that in normal colon tissues (10.3%) and colon adenomas (44.9%) (P <0.05). The positive expression rate of IGF-I protein in colon cancer tissues (62.3%) was significantly higher than that in normal colon tissues (5.2%) (P <0.01) and colon adenomas (41.9%) (P <0.05). Univariate analysis showed that the protein expression of IGF-IR was correlated with Dukes stage, tumor differentiation and gross type of tumor (P <0.05, P <0.01). The protein expression of IGF-I was correlated with Dukes stage and tumor differentiation (P < 0.05, P <0.01). Multivariate Cox regression analysis showed that the degree of differentiation, Dukes staging, IGF-I and IGF-IR protein expression were independent prognostic factors in patients with colon cancer (P <0.05, P <0.01). Conclusions IGF-I and IGF-IR are involved in the development of colon cancer, and may be used as prognostic factors in determining the biological behavior of colon cancer and evaluating the prognosis.