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目的研究胰岛素样生长因子1受体(IGF-1R)表达水平与直肠癌放射治疗(简称放疗)敏感性的关系。方法选择江苏省中医院消化肿瘤外科2009年1月至2010年12月期间的87例直肠癌患者,应用免疫组织化学和逆转录聚合酶链反应(RT-PCR)方法检测直肠癌放疗前活检标本及相应的术后标本中IGF-1R蛋白和mRNA的表达;放疗敏感性评分参照直肠癌消退分级(RCRG)。结果与放疗前活检标本相比,配对的放疗后标本中残留的直肠癌肿瘤细胞中IGF-1R表达水平明显升高(P<0.001)。放疗前直肠癌活检标本中IGF-1R蛋白强表达与放疗耐受有显著相关性(rs=0.401,P<0.001);RT-PCR结果同样显示,IGF-1RmRNA阴性表达者具有更高的放疗敏感性(rs=0.497,P<0.001)。结论直肠癌IGF-1R高表达提示患者术前放疗耐受。
Objective To investigate the relationship between the expression of insulin-like growth factor 1 receptor (IGF-1R) and the sensitivity of radiation therapy for rectal cancer (referred to as radiotherapy). Methods 87 cases of rectal cancer patients from January 2009 to December 2010 in Department of Digestive Oncology, Jiangsu Provincial Hospital of Traditional Chinese Medicine were collected. The biopsy specimens of rectal cancer before radiotherapy were detected by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR) And corresponding postoperative specimens of IGF-1R protein and mRNA expression; radiosensitivity score with reference to rectal cancer regression classification (RCRG). Results Compared with the biopsy specimens before radiotherapy, the expression of IGF-1R in the residual rectal cancer cells in the matched radiotherapy specimens was significantly increased (P <0.001). The strong expression of IGF-1R protein in the biopsy specimens of rectal cancer before radiotherapy was significantly correlated with the radiotherapy tolerance (rs = 0.401, P <0.001). RT-PCR also showed that the negative expression of IGF-1R mRNA was associated with higher radiosensitivity (Rs = 0.497, P <0.001). Conclusion The high expression of IGF-1R in rectal cancer suggests that patients should have preoperative radiotherapy tolerance.