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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 Insulin-like growth factor (IGF) is involved in the tumorigenesis, and its biological effect is caused by binding with its receptor. However, its mechanism in endometrioid adenocarcinoma is unknown. To investigate the relationship between the expression of estrogen-like growth factor receptor (IGFR) and estrogen receptor (ER) α and ERβ proteins in endometrioid adenocarcinoma and its relationship with clinicopathological features. Methods 80 patients with endometrial adenocarcinoma (cancer tissue) paraffin embedded tissue, 22 patients with normal endometrial tissue (normal group) and 33 patients with atypical hyperplasia (atypical hyperplasia group) were treated with EnVision II The expressions of ERα, ERβ, IGF-1R and IGF-2R proteins were detected by immunohistochemical staining and immunohistochemistry. Their relationship with clinicopathological features was analyzed. Results The positive rates of ERα protein were 100%, 95.7% and 73.8% in normal group, atypical hyperplasia group and cancer group respectively. The strong positive rates were 100%, 93.9% and 12.5% respectively. The positive rates of ERβprotein expression in the three groups were 59.1%, 78.8% and 97.5%, respectively. The strong positive rates were 13.6%, 45.5% and 93.8% respectively. The positive rates of IGF-1R protein in the three groups were 63.6%, 75.8% and 90.0%, respectively. The positive rates of IGF-1R protein were 5%, 27.3% and 4% respectively. The positive rates of IGF-2R were 72.7%, 81.8% and 18.8 %, Respectively. The positive rates were 45.5%, 75.8% and 12.5% respectively. There were significant differences among the three groups (P <0.05). There was a moderate negative correlation between ERα protein expression and clinical stage and grade. The correlation coefficient was -0.468, -0.386, P <0.05, but not related to the depth of invasion and menopausal status. There was no correlation between ERβ and staging, grade, depth of invasion and menopausal status. IGF-1R protein expression was positively correlated with stage, grade and depth of invasion, the correlation coefficient was 0.616,0.628,0.546, P <0.05; The correlation coefficient -0.379, with statistical significance (P <0.05), had no correlation with other clinical features. Conclusion The high expression of ERα and IGF-2R proteins is a good symbol of the prognosis of endometrial adenocarcinoma. On the contrary, the low expression of ERα protein and the high expression of IGF-1R protein suggest that the prognosis of endometrial adenocarcinoma is poor.