胰岛素样生长因子-Ⅰ及Ⅰ型受体在子宫内膜增生及内膜腺癌中的表达

目的:探讨胰岛素样生长因-I(IGF-I)、胰岛素样生长因子-I受体(IGF-IR)在子宫内膜增生性病变及内膜腺癌中的表达,为临床交界性内膜疾病的鉴别寻找新的分子标记物。方法:采用免疫组织化学SP法检测20例正常子宫内膜(正常组)、48例子宫内膜增生(增生组)及30例内膜腺癌(腺癌组)中IGF-I/IR的表达。结果:①不典型增生(ATH)腺上皮细胞IGF-I的组织学评分为(5·3±1·1)分,显著低于复杂性增生的(9·6±1·7)分,两者比较,差异有显著性(P<0·01);IGF-IR在ATH的组织学评分[(8·2±1·3)分]较单纯性增生[(4·2±1·6)分]明显增高(P<0·01)。②IGF-I/IR与腺癌的临床分期和组织学分级无相关性(r=0·308~0·524,P>0·05)。③腺癌组IGF-I的组织学评分为(7·1±2·0)分,与正常组的(4·4±0·9)分比较,无显著性差异(P>0·05),而在良性增生内膜的组织学评分[(8·6±1·8)分]却明显高于正常组和ATH(P<0·01);腺癌组IGF-IR的组织学评分为(9·3±1·7)分,与ATH比较,无显著性差异(P>0·05),但二者较正常组[(4·0±0·6)分]和良性增生[(4·8±1·1)分]明显增高(P<0·01)。结论:IGF-IR可有望作为临床鉴别内膜细胞良恶性增生及癌变的重要分子标记物。

Expression of insulin-like growth factor-Ⅰ,-Ⅰ receptor in endometrial hyperplasia and adenocarcinoma

Objective:To evaluate the expression of IGF-Ⅰ/-ⅠR in endometrial hyperplasia and endometrial adenocarcinoma, and thus to explore new molecular indicators for differential diagnosis for endometrial borderline diseases.Methods:Immunohistochemical staining for IGF-I/-IR were performed by SP in 20 cases of normal endometrium, 48 cases of endometrial hyperplasia and 30 cases of endometrial carcinomas.Results:IGF-Ⅰ H-score of atypical hyperplasia (ATH) was significantly low relative to complex hyperplasia(5.3±1.1 versus 9.6±1.7,P<0.01),nevertheless, IGF-ⅠR H-score of ATH was significantly high compared with that of simple hyperplasia (8.2±1.3 versus 4.2±1.6,P<0.01).②No apparent linear relationship was detected between IGF-Ⅰ/-ⅠR and clinical stage & histological grade of endometrial adenocarcinomas (r=0.308～0.524,P>0.05).③Any significant difference in the IGF-Ⅰ H-score was found between endometrial adenocarcinomas and nomal endometrium(7.1±2.0 versus 4.4±0.9,P>0.05).Instead, its H-score of benign hyperplasia(8.6±1.8)was much higher than that of normal endometrium and ATH (P<0.01).In marked contrast to normal endometrium and benign hyperplasia (4.0±0.6 and 4.8±1.1), IGF-ⅠR H-score of endometrial adenocarcinomas (9.3±1.7) increased significantly (P<0.01), but showing no difference compared with ATH (P>0.05).Conclusion:IGF-ⅠR may be used to differentiate the benign, malignant hyperplasia and tumorigenesis as an important molecular indicator.