胰岛素样生长因子1在非小细胞肺癌中的表达及其预后价值

Expression and prognostic significance of insulin-like growth factor 1 in non-small-cell lung cancer

目的:研究胰岛素样生长因子1(IGF1)在非小细胞肺癌组织中的表达,探讨其与肺癌临床病理学特征和生存时间的关系。方法:采用免疫组织化学和免疫印迹技术检测IGF1在29例肺鳞癌和22例肺腺癌(25例含癌旁肺组织)及12例良性肺病变组织中的表达。采用χ2检验检测其与临床病理学特征的关系,Log-rank检验IGF1表达与生存时间的关系,Cox模型作单因素和多因素预后分析。结果:IGF1在肺癌中的阳性表达率为51%(26/51),表达率和强度显著高于良性肺组织(P分别为0.0143和0.0039)。晚期肺癌(Ⅲ+Ⅳ)IGF1阳性表达率和强度显著高于早期肺癌(Ⅰ+Ⅱ)(P分别为0.0032和0.0094)。IGF1在伴有局部淋巴结转移肺癌组织中的阳性表达率显著高于无淋巴结转移肺癌组织中的表达(P=0.0074)。IGF1阳性表达患者的中位生存时间显著短于IGF1阴性者(12个月比35个月,P=0.0001),Cox模型分析表明,IGF1表达是非小细胞肺癌的独立预后因素。结论:本研究结果提示,IGF1过表达在非小细胞肺癌的发生和发展中可能起重要作用,检测IGF1表达有望成为判断非小细胞肺癌预后的参考指标之一。

Purpose： To investigate the expression of insulin-like growth factor Ⅰ（IGF1）in non-small-cell lung cancer（NSCLG）as well as the correlation between IGF1 expressios and clinical follow-up.Methods：The expression of IGF1 was investigated in 51 specimens from patients with NSCLC（29 squamons cell carcinoma.22 adencoarcinoma.25 cases contained normal lung tissue adjacent to cancer）and in 12 specimens from patients with beign lung diseases by immunohistochemistry and western bloting.The correlation between IGF1 expression and clinicopathological characteristics or survival time was analyzed by Chi-square lest or log-rank test,respectively,while univariate and multvariate prognostic analyses were performed by using Cox regression model.Results：With a positive percentage of 51%（26/51）in NSCLC, IGF1 was overexpressed in NSCLC compared to begign lung tissues,reganding both percentage of positive tissues and intensity of the immunoreacivity（P=0.0143 and 0.0039,respectively）.The expression of IGF1 was significantly higher in lung cancers with higher stages（Ⅲ＋Ⅳ）than in those with ower stages（Ⅰ＋Ⅱ）,with respect to percentage of positive tissues and intensity of IGF1（P=0.0032 and 0.0094,respectively）.In addition,the positive percentage of IGF1 was statistically higher in long cancer with metastasis in local lymph node than those without metastasis in local lymph node（P=0.0074）.IGF1-positive cases were correlated with significantly shorter patient survival（median,12 months for positive cases yersus 35 months for negative cases,P=0.0001）,Statistical analysis revealed that IGF1 expression was an independent prognostie factor of NSCLC.Conclusions： The results suggest that the overexpression of IGF1 may play an important role in the initiation and progression of NSCLC;the expression of IGF1 may he valuable in prognosis of NSCLC.