胰岛素样生长因子-1受体在子宫内膜癌中的表达及临床意义

目的 研究子宫内膜癌组织中IGF-1R的分布、表达及其临床意义。方法 选取30例子宫内膜癌手术标本，石蜡切片，采用PV-600PicTureTM检测试剂进行免疫组化，测定IGF-1R的分布及表达，分析与临床病理之间的关系。另取10例正常的增生期子宫内膜标本作为对照。结果 IGF-1R为膜受体。IGF-1R在10例正常增生期子宫内膜细胞中的阳性表达率为70％，无过度表达；而在30例子宫内膜癌细胞中的阳性表达率为90％，过度表达率为40％（中度阳性7例、强阳性5例）。统计表明，正常增生期子宫内膜细胞与子宫内膜癌细胞相比IGF-1R阳性表达率差异尤显著性（P=0．13）；IGF-1R过度表达率差异有显著性（P=0．017）。子宫内膜癌细胞膜IGF-1R阳性表达及过度表达在高分化与中、低分化之间有显著差异（与分级呈负相关系：分化越低，IGF-1R的表达越强，反之，分化高，IGF-1R的表达则弱）。IGF-1R的阳性表达及过度表达在临床分期Ⅰ-Ⅲ期各组间均无明显差异。结论 IGF-1R在子宫内膜癌细胞膜表达，且随恶性程度的增加其表达量增加，IGF-1R的表达量可以预测内膜癌的预后，对临床治疗可能具有一定的指导意义。

Insulin-like growth factor-1 receptor expression and their clinical significance in endometrial adenocarcinoma

Objective To explore the insulin-like growth factor-1 receptor (IGF-1R) distribution, expression and its clinical significance in endometrial adenocarcinoma. Methods The tissue specimens of 30 patients with endometrial adenocarcinoma were formalin-fixed, paraffin-embedded, cut and mounted onto the slides. Sections were stained for IGF-1R immunohistochemically. Ten specimens of normal endometrium at proliferative phase served as control. Results IGF-1R were membrane receptors. Seventy percent specimens of the control group were positive staining of IGF-1R, without overexpression. Positive expression of IGF-1R was in 90% of the cancer, with overexpression in 40% (moderate staining in 7 cases and strong staining in 5 cases). No significant difference of positive expression rate was observed in cancer and normal groups (P=0.13), but significant difference of overexpression rates was obtained between normal and cancer groups (P=0.017). More poorly differentiated tumors were found in IGF-1R positive or overexpressed group than in IGF-1R negative specimens. Positive expression and overexpression of IGF-1R were not associated with the clinical staging. Conclusions IGF-1R is membrane receptors and is related to poor differentiation of the cancer. IGF-1R may be used as an indicator for prognosis of the endometrial adenocarcinoma and provide some theoretic basis of the multiple strategies for management of the endometrial adenocarcinoma.