IGF-Ⅰ、IGF-ⅠR、IGF-Ⅱ在结直肠腺瘤中的表达及意义

摘要

目的: 探讨胰岛素样生长因子(insulin-like growth factor, IGF)-Ⅰ、IGF-ⅠR、IGF-Ⅱ在结直肠腺瘤中的表达及意义.

方法: 选取2011-01/2013-06在我院内镜中心行电子结肠镜检查并3/4活检病理确诊的100例结直肠腺瘤(colorectal adenoma, CRA), 30例结直肠癌(colorectal cancer, CRC), 30例炎性息肉, 同期20例正常结直肠黏膜作为阴性对照组; 应用免疫组织化学SP法检测IGF-Ⅰ、IGF-ⅠR、IGF-Ⅱ的表达.

结果: IGF-Ⅰ、IGF-ⅠR、IGF-Ⅱ的阳性表达在正常结直肠黏膜组(5.0%、10.0%、10.0%)与炎性息肉组(6.7%、10.0%、10.0%)无统计学差异(P>0.05), 正常结直肠黏膜组和炎性息肉组与CRA组(36.0%、48.0%、44.0%)、CRC组(63.3%、80.0%、73.3%)比较呈逐渐增加趋势, 差异有明显统计学意义(P<0.01); 在CRA组, IGF-Ⅰ、IGF-ⅠR、IGF-Ⅱ的阳性表达与性别、年龄、数量、部位均无明显关系(P>0.05), 与腺瘤大小、增生程度、组织学分类有显著统计学差异(P<0.01); 在CRA组, IGF-Ⅰ、IGF-ⅠR、IGF-Ⅱ的表达相互间呈正相关(P<0.01).

结论: 在正常人群的结、直肠黏膜向腺瘤的转化, 以及腺瘤的增长和转化过程中, IGFs和IGFs-R轴发挥着极其重要作用, 因此IGF-Ⅰ、IGF-ⅠR、IGF-Ⅱ有可能作为结肠腺瘤癌变的预测指标, 对临床早期诊治具有重要意义.

关键词: 结直肠腺瘤; 胰岛素样生长因子Ⅰ; 胰岛素样生长因子Ⅱ; 胰岛素样生长因子Ⅰ受体; 免疫组织化学

核心提示: 胰岛素样生长因子(insulin-like growth factor, IGF)-Ⅰ、IGF-ⅠR、IGF-Ⅱ在结直肠腺瘤(colorectal adenoma, CRA)异常表达及相关性与CRA癌变密切相关, 可能通过促进细胞异常增殖、抑制肿瘤细胞凋亡, 而导致腺瘤癌变的发生, 显示IGFs和IGFs-R轴在正常人群的结、直肠黏膜向腺瘤的转化, 以及腺瘤的增长和转化过程中, 发挥着极其重要作用, 可作为结直肠腺瘤癌变的预测指标.

Significance of expression of IGF-Ⅰ, IGF-ⅠR and IGF-Ⅱ in colorectal adenoma

Xiao-Lin Tan, Xiang-Yu Liu, Xian-Jun Mi, Cai-Hong Xie, Chao Zhao, Dong-Mei Chen, Wen Xiao, Quan Yin, Wei-Jian Shi

Xiao-Lin Tan, Cai-Hong Xie, Chao Zhao, Dong-Mei Chen, Wen Xiao, Quan Yin, Wei-Jian Shi, Department of Gastroenterology, Boai Hospital of Zhongshan City of Southern Medical University, Zhongshan 528403, Guangdong Province, China

Xiang-Yu Liu, Xian-Jun Mi, Department of Pathology, Boai Hospital of Zhongshan City of Southern Medical University, Zhongshan 528403, Guangdong Province, China

Supported by: the Foundation of Zhongshan City Science and Technology Bureau, No. 20113A124.

Correspondence to: Xiao-Lin Tan, Associate Chief Physician, Department of Gastroenterology, Boai Hospital of Zhongshan City of Southern Medical University, 6 Chenggui Road, East District, Zhongshan 528403, Guangdong Province, China. 283428256@qq.com

Received: November 27, 2013
Revised: December 24, 2013
Accepted: December 27, 2013
Published online: February 18, 2014

Abstract

AIM: To explore the significance of expression of insulin-like growth factor (IGF)-Ⅰ, IGF-Ⅰ receptor (IGF-ⅠR) and IGF-Ⅱ in colorectal adenoma.

METHODS: Specimens were collected from 100 patients with colorectal adenoma (CRA), 30 patients with colorectal cancer (CRC) and 30 patients with inflammatory polyps who underwent colonoscopy and pathological biopsy at Boai Hospital from January 2011 to June 2013. Twenty cases of normal colorectal mucosa were used as a negative control group. Expression of IGF-Ⅰ, IGF-ⅠR, and IGF-Ⅱ in the specimens was detected by immunohistochemical SP method.

RESULTS: There were no significant differences in the positive rates of IGF-Ⅰ, IGF-ⅠR and IGF-Ⅱ expression between the normal colorectal mucosa group and inflammatory polyps group (5.0% vs 6.7%, 10.0% vs 10.0%, 10.0% vs 10.0%, P > 0.05 for all); however, significant differences were observed in the normal colorectal mucosa group and inflammatory polyps group when compared with the CRA group (36.0%, 48.0%, 44.0%) and CRC group (63.3%, 80.0%, 73.3%) (P < 0.01 for all). In the CRA group, the positive expression of IGF-Ⅰ, IGF-ⅠR and IGF-Ⅱ was significantly correlated with adenoma size, hyperplastic degree and histological classification (P < 0.01 for all), but not with gender, age, number, or site of the adenoma (P > 0.05 for all). In the CRA group, there were positive correlations between the expression of IGF-Ⅰ, IGF-ⅠR and IGF-Ⅱ (P < 0.01 for all).

CONCLUSION: The IGFs/IGFs-R axis plays an important role in the transformation of normal colorectal mucosa to adenoma and in growth and transformation of the adenoma. IGF-Ⅰ, IGF-ⅠR and IGF-Ⅱ can be used as predictive indices for malignant transformation of colorectal adenoma.

Key Words: Colorectal Adenoma; Insulin-like growth factorⅠ; Insulin-like growth factor Ⅱ; Insulin-like growth factorⅠreceptor; Immunohistochemistry

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参考文献

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