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目的探讨胰岛素受体α(IRα)、β(IRβ)及胰岛素受体底物-1(IRS-1)在子宫内膜癌的表达及其临床意义。方法用免疫组织化学法检测10例正常子宫内膜、18例子宫内膜增生及57例子宫内膜癌组织中IRα、IRβ及IRS-1蛋白的表达。结果IRα、IRβ、IRS-1的表达在10正常子宫内膜表达分别为80.00%(8/10)、60.00%(6/10)及70.00%(7/10);在18例子宫内膜增生组织中分别为77.78%(14/18)、61.11%(11/18)及77.78%(14/18);在子宫内膜癌组织中分别为47.37%(27/57)、54.39%(31/57)及63.16%(36/57)。IRα的表达在子宫内膜癌组织与正常子宫内膜组及子宫内膜增生比较差异有显著性(P<0.05),其余差异无统计学意义(P>0.05);Ⅰ期子宫内膜癌组织中IRα的阳性表达率明显低于Ⅱ~Ⅳ期者(P>0.05);IRβ及IRS-1各组间的阳性表达率与Ⅱ~Ⅳ期者相近(P>0.05);IRS-1的阳性表达率Ⅰ期明显低于Ⅱ~Ⅳ期者(P>0.05);IRα、β、IRS-1蛋白的表达在子宫内膜癌G1-2与G3差异有显著性(P<0.05),与肌层浸润深度及淋巴结转移与否差异无显著性(P>0.05)。结论IRα及IRS-1的表达与子宫内膜癌的期别有关,提示其表达的改变可能是子宫内膜腺癌发生的早期事件。
Objective To investigate the expression of IRα, β (IRβ) and insulin receptor substrate-1 (IRS-1) in endometrial carcinoma and its clinical significance. Methods The expressions of IRα, IRβ and IRS-1 in 10 cases of normal endometrium, 18 cases of endometrial hyperplasia and 57 cases of endometrial carcinoma were detected by immunohistochemistry. Results The expression of IRα, IRβ and IRS-1 in 10 normal endometrium was 80.00% (8/10), 60.00% (6/10) and 70.00% (7/10), respectively. In 18 cases of endometrial hyperplasia In the endometrial carcinoma tissues, they were 77.78% (14/18), 61.11% (11/18) and 77.78% (14/18), respectively, which were 47.37% (27/57) and 54.39% (31 / 57) and 63.16% (36/57). IRα expression in endometrial cancer tissue and normal endometrium group and endometrial hyperplasia were significantly different (P <0.05), the other no significant difference (P> 0.05); Ⅰ endometrial cancer tissue (P> 0.05). The positive rates of IRα and IRS-1 in each group were similar to those in Ⅱ ~ Ⅳ (P> 0.05). The positive rate of IRS-1 The expression of IRα, β, IRS-1 protein was significantly different from that of G3 in endometrial carcinoma (P <0.05), and the expression rate in stage Ⅰ was significantly lower than that in stage Ⅱ ~ Ⅳ (P> 0.05) There was no significant difference in depth of invasion and lymph node metastasis (P> 0.05). Conclusion The expressions of IRα and IRS-1 are correlated with the stage of endometrial carcinoma, suggesting that the change of IRα and IRS-1 may be an early event of endometrial adenocarcinoma.