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目的:研究胰岛素样生长因子Ⅰ受体(IGF-ⅠR)在大肠息肉和大肠癌中的表达及其意义。方法:收集内镜下黏膜切除技术(EMR)或黏膜下层剥离术(ESD)完整切除并经病理确诊的32例患者的47个大肠息肉,包括炎性息肉、管状腺瘤、绒毛状腺瘤;另选12例正常结肠黏膜组织及20例结肠腺癌黏膜组织作为对照。用免疫组化SP法检测IGF-ⅠR的表达,分析IGF-ⅠR的表达程度及其与大肠癌的相关性。结果:经Mann-WhitneyU检验炎性息肉IGF-ⅠR与其正常黏膜中IGF-ⅠR比较差异无统计学意义,P=0.251;经Mann-WhitneyU检验管状腺瘤、绒毛状腺瘤IGF-ⅠR与其正常黏膜IGF-ⅠR间差异有统计学意义,P均<0.001,故管状腺瘤、绒毛状腺瘤IGF-ⅠR水平比其正常黏膜高。IGF-ⅠR在正常对照组、炎性息肉组、管状腺瘤组、绒毛状腺瘤组和大肠癌组5组病例间经Spearman’s双变量等级相关性分析,差异有统计学意义,r=0.574,P<0.001。3组之间从年龄、性别及病例数差异无统计学意义,P>0.05。结论:管状腺瘤、绒毛状腺瘤IGF-ⅠR水平比其正常黏膜高;IGF-ⅠR在正常组织、炎性息肉、管状腺瘤、绒毛状腺瘤和大肠癌中的表达依次增加。IGF-ⅠR在评价息肉处于黏膜增生-腺瘤-癌变的发展中起了重要的作用。
Objective: To investigate the expression and significance of insulin-like growth factor receptor (IGF-ⅠR) in colorectal polyps and colorectal carcinoma. Methods: Totally 47 colorectal polyps, including inflammatory polyp, tubular adenoma and villous adenoma, were collected from 32 patients who had undergone endoscopic mucosal resection (EMR) or submucosal dissection (ESD) Another 12 cases of normal colon mucosa tissue and 20 cases of colon adenocarcinoma mucosa as a control. Immunohistochemical SP method was used to detect the expression of IGF-IR, and to analyze the expression of IGF-IR and its correlation with colorectal cancer. Results: Mann-WhitneyU test showed that there was no significant difference between IGF-ⅠR in inflammatory polyp and IGF-ⅠR in normal mucosa (P = 0.251). The Mann-WhitneyU test showed that tubular-type adenoma and villous adenoma IGF- The difference between IGF-ⅠR was statistically significant, P <0.001, so tubular adenoma, villous adenoma IGF-ⅠR levels higher than its normal mucosa. IGF-ⅠR in the control group, inflammatory polyp group, tubular adenoma group, villous adenoma group and colorectal cancer group 5 cases by Spearman’s bivariate grade correlation analysis, the difference was statistically significant, r = 0.574, P <0.001.3 between the groups from the age, gender and case number difference was not statistically significant, P> 0.05. CONCLUSIONS: The levels of IGF-ⅠR in tubular adenoma and villous adenoma are higher than those in normal mucosa. The expression of IGF-ⅠR in normal tissue, inflammatory polyp, tubular adenoma, villous adenoma and colorectal cancer increases in turn. IGF-IR plays an important role in the evaluation of polyps in the development of mucosal hyperplasia-adenoma-carcinogenesis.