Study On Expression Characteristics Of IGF-1R In Breast Cancer Tissue With Or Without Diabetes And The Associated Factors

BackgroundBreast cancer is the most common malignant tumors in females. In recent years, the incidence of breast cancer is rising, and it has been the first malignant tumor endangering women’s health. According to the WHO reports in2008,1.38million women were new diagnosed cases of breast cancer in the whole world each year, and there were about460,000women died of breast cancer. From2003to2007, the total incidence of female breast cancer in China was about41.64/100,000, and breast cancer was the most of malignant tumors in women. Breast cancer brought much serious damage to both women’s health and life. With the improvement of living standards, changing of life style, the incidence of diabetes is increasing worldwide. The association between diabetes and cancer, including breast cancer, is attaching more and more attention. Along with the development of cancer research and molecular biology, the role of insulin-like growth factor (IGFs) system in the cancer occurrence and development has attached people’s attention gradually. Insulin-like growth factor1receptor (IGF-IR) is one of the important members of IGFs system, and studies have shown that IGF-IR has the effect of promoting proliferation of cell division, and a kind of potential mitogen. IGF-IR was expressed in various types of cancer. Our study aims to explore the expression characteristics of IGF-IR in breast cancer tissue, and the related factors to the expression characteristics of IGF-IR, and whether it is affected by diabetes mellitus, in order to provide theoretical basis for targeted therapy using IGF-IR antibodies in subtypes of breast cancer. Objectives2.1To detect the expression characteristics of IGF-1R in breast cancer tissue, and analyze the correlation between breast cancer patients’basic information, clinical pathological features, immunohistochemical index and the expression of IGF-1R;2.2To explore the relationship between the expression of IGF-1R and the basic information, clinical pathologic information, history of diabetes mellitus, blood sugar levels (accompanied by diabetes mellitus group) in breast cancers with diabetes mellitus and without;2.3To understand the change of the expression of IGF-1R before and after neoadjuvant chemotherapy.MethodsResearch materials of subjects were collected from January1,2010to December31,2012in breast surgery, the second hospital of Shandong University, and all the female were diagnosed with breast cancer, which were confirmed by pathology, and223carcinoma cases tissue specimens of paraffin were collected. Immune histochemical method was used to detect the expression of IGF-1R in breast cancer tissue, and making a retrospective study between the expression of IGF-1R in patients with breast cancer and their foundation data, female physiology condition, history of cancer, clinical pathologic features, and different kinds of pathological type and hormone receptors. SPSS16.0software was used for data analysis, and using the chi-square test, univariate Logistic regression and multivariate Logistic regression.Main results4.1The expression of IGF-1RThe expression of IGF-1R was detected in223cases of breast cancer tissues in our study.113cases were negative with the negative expression rate being50.7%.110cases were positive with the rate being49.3%. Among the positive ones,+for weakly positive expression, there were45cases (40.9%);++for moderate intensity expression, there were52cases (47.3%);+++for strong positive expression, there were13cases (11.8%). 4.2Breast cancer patients’ basic information and physiology charactersThe ages of the whole223patients ranged from22to83years old, and the average age was51.56±11.87years. There were2cases who were ethnic minorities, Man and Hui nationality. And the rest was Han nationality. There were25breast cancer patients with diabetes, accounting for11.2%of all the223patients, and198patients without diabetes, accounting for88.8%.The expression of IGF-1R in the distribution of various age groups and the different races、 occupation history of diseases, including high blood pressure, diabetes, heart disease, breast benign tumor, uterine fibroids and ovarian cyst, and the size of the tumor, the pathological types and the ER, PR, CerB-2status had no statistical significance (p>0.05).4.3In the diabetes group, the distribution of pathological types and the expression of IGF-1R were statistically different, and univariate Logistic regression analysis found no factor was statistically correlated with the expression of IGF-1R.4.4In non-diabetic group, the distribution of age, menarche age, time from mentioning the tumor to go to see a doctor, and lymph node metastasis status was statistically different with the expression of IGF-1R, and univariate Logistic regression analysis found that the time from mentioning the tumor to go to see a doctor, menarche age, family history of cancer, lymph node metastasis status and CerB-2status are the dangerous factors for the positive expression of IGF-1R. Multivariate Logistic regression analysis found that lymph node metastasis status was associated with positive expression of IGF-1R (OR=2.258,95%CI:2.258-4.235).4.5Neoadjuvant chemotherapy could reduce the positive expression of IGF-1R level; for the negative expression of IGF-1R might increase its expression.Conclusions5.1The expression of IGF-1R was associated with the time from realizing the tumor to see a doctor, lymph node metastasis status.5.2In non-diabetic group of breast cancer, the multivariate Logistic regression study found that the time from realizing the tumor to see a doctor, family history of cancer, lymph node status and CerB-2status were related to the expression of IGF-1R. 5.3Neoadjuvant chemotherapy could partly effectively reduce the degree of positive expression of IGF-IR. In the subsequent new auxiliary, we could test the expression of IGF-IR, in order to evaluate the tumor sensitivity to the using chemotherapy, and the effect of the chemotherapy.