胰岛素样生长因子1在肺腺癌中的表达及意义

Expression and clinical role of insulin-like growth factor 1 in adenocarcinoma of lung

目的研究胰岛素样生长因子(IGF)1在肺腺癌组织中的表达,探讨其与肺腺癌生存期的关系。方法采用免疫组织化学方法检测49例肺腺癌组织(均含癌旁肺组织)中的IGF1表达。采用χ2检验检测IGF1表达与临床病理学特征的关系,Log-rank检验分析IGF1表达与生存期的关系。结果 49例肺腺癌标本中IGF1表达阴性或弱阳性24例,阳性或强阳性25例。女性患者的肺腺癌组织中的IGF1阳性表达率显著高于男性患者(P=0.020),伴有局部淋巴结转移患者的肺腺癌组织中的IGF1阳性表达率显著高于无淋巴结转移患者(P=0.000),不同分化程度患者的肺腺癌组织中的IGF1阳性表达率的差异无统计学意义(P=0.284)。IGF1表达阴性或弱阳性患者的中位生存时间为58.2个月(95%CI为48.4～68.0),显著长于IGF1表达阳性或强阳性患者的40.0个月(95%CI为31.3～48.4,P=0.01)。结论肺腺癌组织中的IGF1表达与性别和淋巴结转移情况有关,检测IGF1有助于肺腺癌的预后判断。

Objective To investigate the expression of insulin-like growth factor （IGF） 1 in adenocarcinoma of lung and its relationship with the survival time. Methods The expression of IGF1 was detected in 49 specimens from patients with adenocarcinoma of lung （All contained normal lung tissue adjacent to cancer） by immunohistochemistry. The correlation between IGF1 and clinical pathology was analyzed by Chi square test, and the correlation between IGF1 and survival time was investigated by Log-rank analysis. Results The expression of IGF1 was negative or weakly positive in 24 cases and positive or strongly positive in 25 cases. The expression of IGF1 in females was significantly higher than in males （P = 0. 020）. IGF1 level in the patients with regional lymph node metastasis was significantly higher than those without metastasis （P = 0. 000）. There was no significant difference in IGF1 expression between different adenocarcinoma differentiation （P = 0. 284）. Median survival time in the IGF1-negative or weakly positive cases （58. 2 months, 95% CI： 48. 4 - 68. 0） were significantly longer than that in the IGF1-positive or strongly positive cases （40 months, 95% Cl= 31.3 - 48.4, P=0.01）. Conclusion The expression of IGF1 in lung adenocarcinoma is related to gender and metastasis of lymph node. IGF1 level may be helpful to prognose adenocarcinoma of lung.