结直肠癌组织IGF-1和IGFBP-3表达临床意义分析

目的：探讨IGF-1和IGFBP-3在结直肠癌（colorectalcancer，CRC）组织中的表达及其临床意义。方法：选取承德医学院附属保定市第-中心医院2005-06—13—2012—12—27接受手术治疗的CRC患者183例作为观察组，并对其中61例取其癌旁正常黏膜组织作为对照组，应用免疫组化SP法分别检测IGF-1和IGFBP-3在两组的表达情况。结果：IGF-1在CRC中的阳性表达率60．1％（110／183），显著高于对照组31．1％（19／61），P〈0．001；IGFBP-3在CRC中的阳性表达率78．1％（143／183），显著低于对照组95．1％（58／61），P=0．003。IGF-1表达与组织学分级、浸润深度、TNM分期和淋巴结转移有关，P〈0．05；IGFBP-3表达与TNM分期和淋巴结转移有关，P〈0．05；两者与年龄、性别、肿瘤大小、部位和远处转移等均无关，P〉0．05。IGF-1与IGFBP-3表达呈较弱的负相关性，r=-0．188，P-0．011。Logistic多因素回归分析显示，IGF-1在CRC中高表达是TNM分期增高和淋巴结转移的危险因素之一，IGFBP-3低表达是CRC发生淋巴结转移的危险因素之一。结论：IGF-1和IGFBP-3异常表达在CRC的发生发展过程中起重要作用，联合检测IGF-1和IGFBP-3可能成为临床上cRC评估预后新的生物学指标。

Expressions and clinical significance of IGF-1 and IGFBP-3 in colorectal cancer

OBJECTIVE： To investigate the expressions and the clinical significance of IGF-1 and IGFBP-3 in the pathogenesis of colorectal cancer. METHODS： Totally 183 cases of colorectal cancer （CRC） patients who underwent surgical treatment were selected as observation group in Baoding First Central Hospital of Chengde Medical College from June 2005 to December 2012. Sixty-one cases adjacent normal mucosa as control group,and the expressions of IGF-1 and IG- FBP-3 were detected in the two groups by SP immunohistochemical technology. RESULTS： The IGF-1 positive expression rate was 60.1% （110/183） in CRC, which was significantly higher than that in control group （P〈 0. 001）;The positive expression rate of IGFBP-3 was 78. 1% （143/183） in CRC, which was lower than that in control group （95. 1 %, P= 0. 003）. The expression of IGF-1 was related with histological grade, depth of invasion,TNM stage, and lymph node metastasis in colorectal cancer （P〈0. 05）;IGFBP-3 expression in colorectal cancer was related with the TNM stage and lymph node metastasis too （P〈0.05）, both of them were independent factors （P〉0.05）. The expression of IGF-1 and IGFBP-3 in CRC tissues showed weak negative correlation （r= - 0. 188, P = 0.011 ） ; Logistic regression analysis showed that the higher expression of IGF-1 was one of risk factors to the TNM stage and lymph node metastasis. The lower expression of IGFBP-3 was one of risk factors to the lymph node metastasis. CONCLUSIONS： There are correlations be tween the expressions of IGF-1 and IGFBP-3 in development and prognosis of colorectal cancer. Combined detections of IGF-1 and IGFBP-3 can become new biomarkers in assessment of CRC prognosis.