Insulin-like growth factor type 1 receptor expression correlates to good prognosis in highly malignant soft tissue sarcoma.
Insulin-like growth factor type 1 receptor expression correlates to good prognosis in highly malignant soft tissue sarcoma.
复制标题
DOI：
--
复制
发表时间：
2005
期刊：
影响因子：
--
通讯作者：
J. Åhlén;J. Wejde;O. Brosjö;A. von Rosen;W. Weng;L. Girnita;O. Larsson;C. Larsson
中科院分区：
文献类型：
--
作者：
J. Åhlén;J. Wejde;O. Brosjö;A. von Rosen;W. Weng;L. Girnita;O. Larsson;C. Larsson
目的评价已知和建议的高度恶性软组织肉瘤（STS）的预后标志物，特别是胰岛素样生长因子1型受体（IGF-1 R）。实验设计：对101例原发性高恶性度STS患者的转移、局部复发和生存率进行了至少5年的随访研究。免疫组化检测Ki-67、p53、p27、Bcl-2、IGF-1 R的表达及微血管密度。传统的临床变量的大小，恶性程度（3或4），坏死，核分裂频率，浸润性肿瘤生长，血管浸润，深度和手术切缘也进行了评价。结果IGF-1 R的高表达与良好的预后显著相关。在IGF-1 R免疫反应阳性的STS中，高表达（76-100%阳性细胞）的病例结局最好，而低表达（1-25%阳性细胞）的病例结局最差。正如预期的那样，在单变量和多变量分析中，大肿瘤尺寸（>11 cm）、坏死、高核分裂计数、病灶内手术和深部位置均与不良结局显著相关。恶性肿瘤3级与4级病例的结局无差异，而纳入的更客观的变量坏死和有丝分裂计数被认为是可靠的预后标志物。结论IGF-1 R表达是高度恶性STS的共同特征。进一步阐明IGF-1 R和IGF系统在STS中的作用，不仅可以为STS中新的预后工具的开发提供基础，而且可以阐明STS发生发展的基本机制。
PURPOSE To evaluate known and suggested prognostic markers, especially insulin-like growth factor type 1 receptor (IGF-1R), in highly malignant soft tissue sarcomas (STS). EXPERIMENTAL DESIGN A cohort of 101 patients with primary STS of high malignancy grade was studied with respect to development of metastasis, local recurrence, and survival during a minimum of 5 years follow-up. All tumors were analyzed by immunohistochemistry for expression of Ki-67, p53, p27, Bcl-2, IGF-1R, and microvessel density. The traditional clinical variables size, malignancy grade (3 or 4), necrosis, mitotic frequency, infiltrative tumor growth, vascular invasion, depth, and surgical margins were also evaluated. RESULTS A significant association was shown between high expression of IGF-1R and favorable outcome. Among STS with positive IGF-1R immunoreactivity, cases with high expression (76-100% positive cells) had the best outcome, whereas cases with the lowest expression (1-25% positive cells) had the worst. As expected, large tumor size (>11 cm), presence of necrosis, high mitotic count, intralesional surgery, and deep location were all significantly associated with poor outcome, both in univariate and multivariate analyses. No difference in outcome was observed between cases of malignancy grade 3 versus 4, whereas the included and more objective variables necrosis and mitotic count were found to be reliable prognostic markers. CONCLUSION IGF-1R expression is a common feature of highly malignant STS. Further elucidation of the role of IGF-1R and the IGF system in STS may both provide a basis for development of new prognostic tools in STS, as well as shed light on the basic mechanisms of the STS development.