IGF-Ⅰ、IGF-ⅠR、IGF-Ⅱ在结直肠腺瘤中的表达及意义

Significance of expression of IGF- I, IGF-I R and IGF-II in colorectal adenoma

目的：探讨胰岛素样生长因子（insulin—like growth factor,IGF）-I、IGF-IR、IGF-II在结直肠腺瘤中的表达及意义方法：选取2011-01／2013—06在我院内镜中心行电子结肠镜检查并经活检病理确诊的100例结直肠腺瘤（colorectal adenoma，CRA），30例结直肠癌（colorectal cancer,CRC），30例炎性息肉，同期20例正常结直肠黏膜作为阴性对照组：应用免疫组织化学SP法检测IGF—I、IGF—IR、IGF—II的表达．结果：IGF—I、IGF．IR、IGF—II的阳性表达在正常结直肠黏膜组（5．0％、10．0％、10．0％）与炎性息肉组f6．7％、10．0％、10．0％）无统计学差异（P〉0．05），正常结直肠黏膜组和炎性息肉组与CRA组（36．0％、48．0％、44．0％、、CRC组（63．3％、80．0％、73．3％）比较呈逐渐增加趋势，差异有明显统计学意义（P〈0．01）；在CRA组，IGF—I、IGF—IR、IGF—II的阳性表达与性别、年龄、数量、部位均无明显关系（P〉0．05），与腺瘤大小、增生程度、组织学分类有显著统计学差异（P〈0．01）：在CRA组，IGF—I、IGF—IR、IGF—II的表达相互间呈正相关（P〈0．01）．结论：在正常人群的结、直肠黏膜向腺瘤的转化，以及腺瘤的增长和转化过程中，IGFs和IGFs—R轴发挥着极其重要作用，因CLIGF-I、IGF-IR、IGF-II有可能作为结肠腺瘤癌变的预测指标，对临床早期诊治具有重要意义．

AIM： To explore the significance of expression of insulin-like growth factor （IGF）- I, IGF- I receptor （IGF- I R） and IGF- II in colorectal adenoma. METHODS： Specimens were collected from 100 patients with colorectal adenoma （CRA）, 30 patients with colorectal cancer （CRC） and 30 patients with inflammatory polyps who underwent colonoscopy and pathological biopsy at Boai Hospital from January 2011 to June 2013. Twenty cases of normal colorectal mucosa were usedas a negative control group. Expression of IGF- I, IGF- I R, and IGF-II in the specimens was detected by immunohistochemical SP method. RESULTS： There were no significant differences in the positive rates of IGF- I, IGF- I R and IGF- II expression between the normal colorectal mucosa group and inflammatory polyps group （5.0% vs 6.7%, 10.0% vs 10.0%, 10.0% vs 10.0%, P 〉 0.05 for all）; however, significant differences were observed in the normal colorectal mucosa group and inflammatory polyps group when compared with the CRA group （36.0%, 48.0%, 44.0%） and CRC group （63.3%, 80.0%, 73.3%） （P 〈 0.01 for all）. In the CRA group, the positive expression of IGF- I, IGF- I R and IGF-II was significantly correlated with adenoma size, hyperplastic degree and histological classification （P 〈 0.01 for all）, but not with gender, age, number, or site of the adenoma （P 〉 0.05 for all）. In the CRA group, there were positive correlations between the expression of IGF- I, IGF- I R and IGF- II （P 〈 0.01 for all）. CONCLUSION： The IGFs/IGFs-R axis plays an important role in the transformation of normal colorectal mucosa to adenoma and in growth and transformation of the adenoma. IGF- I, IGF- I R and IGF-II can be used as predictive indices for malignant transformation of colorectal adenoma.