胰岛素样生长因子Ⅱ与结肠直肠癌患者预后的关系

Relationship between insulin like growth factor Ⅱ and prognosis of colorectal cancer

目的 探讨胰岛素样生长因子Ⅱ (IGF Ⅱ )表达水平与癌细胞的增殖、凋亡及结肠直肠癌患者预后的关系。 方法 结肠直肠腺癌患者 14 2例 ,术前纤维结肠镜直视下采集癌肿和正常结肠直肠粘膜组织标本。以S P法检测IGF Ⅱ ,多媒体图文分析系统定量阳性染色区灰度值。S P法检测增殖细胞核抗原 (PCNA) ,计算PCNA标记指数。TUNEL法检测凋亡细胞 ,计算凋亡指数。患者均作随访 ,观察并记录无病生存时间和总生存时间 ,计算无病生存率 (DFS)和总生存率 (OS)。 结果 结肠直肠癌组织中IGF Ⅱ水平 ( 2 0 2 9± 8 0 4 )显著高于正常粘膜 ( 13 81± 5 86)。IGF Ⅱ灰度值高低与PCNA标记指数、凋亡指数高低显著相关。低IGF Ⅱ表达组结肠直肠癌患者的DFS为 69% ,OS为78% ,均显著高于高IGF Ⅱ表达组 ( 4 2 % ,5 5 % )。Cox分析显示IGF Ⅱ表达高低为除Dukes分期之外的又一独立预后判断指标。 结论 结肠直肠癌组织中IGF Ⅱ表达高低是判断患者预后的新指标。

Objective To investigate the relationship between insulin like growth factor Ⅱ(IGF Ⅱ) and prognosis of colorectal cancer. Methods One hundred and forty two colorectal cancer patients were enrolled. In colonoscopic biopsy specimens,the expression of IGF Ⅱ and PCNA were detected immunohistochemically, while TUNEL technique was used to detect apoptosis. All patients were followed up, and disease free survival (DFS) and overall survival (OS) rate were calculated. Results The expression level of IGF Ⅱ was significantly higher in colorectal cancer than in normal colorectal mucosa. A correlation was observed between more IGF Ⅱ expression, high PCNA labeling index, and apoptotic index was demonstrated. Patients with lower expression level of IGF Ⅱ had higher DFS and OS. Multivariate analysis by means of the Cox proportional hazards model revealed that the expression level of IGF Ⅱ was an independent prognostic predictor in colorectal cancer patients. Conclusion The expression level of IGF Ⅱ is a new prognostic predictor for colorectal cancer.