胰岛素样生长因子受体及雌激素受体在子宫内膜样腺癌中的表达及临床病理意义  

Expressions of insulin-like growth factor receptors and estrogen receptor subtypes in endometrioid adenocarcinoma and their clinicopathologic significance

作　　者：梁元姣[1] 张慧明[1] 郝群[1] 徐艳[2] 季爱华[1] 胡娅莉[3] 

机构地区：[1]南京大学医学院临床学院(南京军区南京总医院)妇产科 [2]南京大学医学院临床学院(南京军区南京总医院)病理科,南京210002 [3]南京市鼓楼医院妇产科,南京210008

出　　处：《医学研究生学报》2011年第5期472-476,共5页Journal of Medical Postgraduates

基　　金：南京军区2008年科技创新项目(08MA092)

摘　　要：目的胰岛素样生长因子(insulin-like growth factor,IGF)参与肿瘤的发生,通过与其受体结合发生生物学效应,但在子宫内膜样腺癌中的作用机制不明,文中旨在探讨IGF受体(insulin-like growth factor receptor,IGFR)及雌激素受体(es-trogen receptor,ER)α、ERβ蛋白质在子宫内膜样腺癌中的表达,及其与临床病理表型特征的关系。方法子宫内膜样腺癌(癌组织组)石蜡包埋组织80例患者,正常内膜组织(正常组)22例患者,不典型增生内膜(不典型增生组)33例患者,采用EnVision二步法进行免疫组化染色,检测ERα、ERβ、IGF-1R、IGF-2R蛋白质的表达,分析它们与临床病理特征间的关系。结果 ERα蛋白质的表达在正常组、不典型增生组及癌组织组中阳性率分别为100%、95.7%、73.8%;强阳性率为100%、93.9%、12.5%。ERβ蛋白质表达在3组中的阳性率为59.1%、78.8%、97.5%;强阳性率分别为13.6%、45.5%、93.8%。IGF-1R蛋白质表达在3组阳性率分别为63.6%、75.8%、90.0%,强阳性率分别为5%、27.3%、4%;IGF-2R的阳性率分别为72.7%、81.8%、18.8%,强阳性率分别为45.5%、75.8%、12.5%,3组比较差异均有统计学意义(P<0.05)。ERα的蛋白质表达与临床分期、分级呈中度负相关,相关系数为-0.468、-0.386,P<0.05,与浸润深度及绝经状态无相关性。ERβ与分期、分级、浸润深度及绝经状态无相关性;IGF-1R蛋白质表达与分期、分级、浸润深度呈正相关,相关系数为0.616、0.628、0.546,P<0.05;而IGF-2R与细胞分化程度呈负相关,相关系数-0.379,有统计学意义(P<0.05),与其他临床特征无相关性。结论 ERα、IGF-2R蛋白质的高表达是内膜样腺癌预后良好的象征;相反,ERα蛋白质低表达、IGF-1R蛋白质高表达提示内膜样腺癌患者预后不良。Objective The insulin-like growth factor(IGF) plays a role in neoplastic pathology through conjunction with their receptors,but the mechanism of the involvement of IGF and their receptors in the occurrence of endometrioid adenocarcinoma is unclear.The aim of this study is to investigate the expressions of IGF receptors(IGFR) and estrogen receptor(ER) subtypes in endometrioid adenocarcinoma and the relationship between their expressions and their clinicopathologic features.Methods We obtained paraffin-embedded tissues of endometrioid adenocarcinoma from 80 patients,of normal endometria from 22,and of atypical hyperplasia from 33.We detected the protein expressions of ERα,ERβ,IGF-1R and IGF-2R by immunohistochemical staining using the EnVision two-step method,and analyzed relationship of the expression patterns of ERα,ERβ and IGF with their clinicopathological characteristics.Results The positive expression rates of the ERα protein were 100%,95.7% and 73.8%,and its strongly positive expression rates were 100%,93.9% and 12.5% in the normal,atypical hyperplasia and endometrioid adenocarcinoma tissues,respectively(P<0.05);those of ERβ were 59.1%,78.8% and 97.5%(P<0.05);those of IGF-1R were 63.6%,75.8% and 90.0%(strongly positive 5%,27.3% and 40.0%)(P<0.05);and those of IGF-2R were 72.7%,81.8% and 18.8%(strongly positive 45.5%,75.8% and 12.5%)(P<0.05).The expression of the ERα protein was negatively correlated with the clinical stage and cell grade(r=-0.468 and-0.386,P<0.05),but not with the depth of infiltration and menopause condition,while the ERβ expression was correlated with none of the above items.The expression of the IGF-1R protein had a positive correlation with the clinical stage,cell grade and infiltration depth(r=0.616,0.628 and 0.546,P<0.05),while that of IGF-2R a negative one with the cell grade(r=-0.379,P<0.05),and no correlation with other clinical features.Conclusion The overexpressions of ERα and IGF-2R proteins might predict a good prognosis of endometrioid adenocarcinoma,while those of IGF

关 键 词：子宫内膜样腺癌 胰岛素样生长因子受体 雌激素受体亚型 免疫组化染色 

分 类 号：R[医药卫生]