胰岛素样生长因子家族在膀胱尿路上皮癌组织中表达及意义

目的探讨胰岛素样生长因子（IGF）-I、IGF—II、胰岛素样生长因子I受体（IGF—IR）、胰岛素样生长因子II受体（IGF-ⅡR）和胰岛素样生长因子结合蛋白（IGFBP）-3、IGFBP-5在膀胱尿路上皮癌（PUCB）中术中的表达及其临床意义。方法将42例PUCB的纽织标本采用免疫组织化学法检测PUCB组织和癌旁组织标本中IGF—I、IGF-Ⅱ、IGF—IR、IGF-ⅡR和IGFBP-3、IGFBP-5的水平。结果IGFs在膀胱尿路上皮细胞癌中的阳性染色表现为棕黄色颗粒，其中IGF—IR、IGF—IIR、IGFBP-3、IGFBP～5表达于上皮细胞的胞膜和胞浆，而IGF—Ⅱ表达于上皮细胞的胞核和胞浆。IGF—I在正常膀胱上皮细胞和PUCB组织中均为阴性表达；IGF-Ⅱ、IGF-ⅡR和IGFBP-5均为阳性表达，在正常组织的表达率分剐为62．96％、50．00％、73．81％；在低级剐尿路上皮癌（LGPUCB）中的表达率分剐为100％、88％、100％，高级别尿路上皮癌（HGPUCB）的表达率分别为100％、88．24％、100％：各组的正常组织与PUCB组织之间比较；差异均有统计学意义（X^2分别=51．24、31-36、33．05，P均〈0．05）；IGF—IR和IGFBP-3亦为阳性表达，在正常组织的表达率分别为21．43％、16．67％，在低级别尿路上皮癌（LGPUCB）中的表达率分别为12．00％、36．00％，高级别尿路上皮癌（HGPUCB）的表达率是47．06％、41．18％，但各组的正常组织与PUCB组织之间比较，差异均无统计学意义（X^2分别：7．12、8．83，P均〉0．05）。结论IGF-Ⅱ、IGF-ⅡR和IGFBP-5在PUCB组织中呈现高表达．对诊断具有临床意义。

Histological expression and clinical effect of insulin-like growth factors in papillary urothelial carcinoma of bladder

Objective To explore the expression and clinical effect of IGF- I ,IGF- I R,IGF-Ⅱ , IGF-Ⅱ R and IGF- BP-3,IGFBP-5 in the tissues of papillary urothelial carcinoma of bladder. Methods Immunohistochemical methods were adopted to examine the expressions of IGF- I ,IGF-Ⅱ ,IGF- I R,IGF-Ⅱ R and IGFBP-3 ,IGFBP-5 of 42 cases with papillary urothelial carcinoma of bladder. Results The positive staining of IGFs in papillary urothelial carcinoma of bladder was huffy granule.The IGF- I R, IGF-Ⅱ R, 1GFBP-3 ,IGFBP-5 were expressed in the cell membrane and cytoplasm while IGF- Ⅱ expressed in nucleus and cytoplasm. The expression of IGF- I in the normal tissue and papillary urothelial carcinoma of bladder were negative while the IGF- Ⅱ ,IGF- Ⅱ R and IGFBP-5 were positive. The rate of expression of IGF-IR ,IGF- Ⅱ ,IGF- Ⅱ R and IGFBP-3,IGFBP-5 were 21.43%, 62.96%, 50.00%, 16.67%, 73.81% in normal tissue and 12.00%, 100%, 88.00%, 36.00%, 100% in LGPUCB respectively and 47.06%, 100% ,88.24%,41.18%, 100% in HGPUCB. Among three groups, IGF-Ⅱ ,IGF-Ⅱ R,IGFBP-5 had statistically differences （X^2=51.24,31.36,33.05, P〈0.05）, but IGF-IR and IGFBP-3 had no statistically differences （X2=7.12,8.83, P〉0.05）. Conclusions There were high expressions of IGF- Ⅱ , IGF- Ⅱ R and IGFBP-5 in the tissue of papillary urothelial carcinoma of bladder.