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Annals of Oncology Advance Access originally published online on March 27, 2008
Annals of Oncology 2008 19(7):1293-1298; doi:10.1093/annonc/mdn040
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

gastrointestinal tumors

Insulin-like growth factor (IGF) 1 and 2 help to predict disease outcome in GIST patients

C. Braconi1,*,{dagger}, R. Bracci1,2,{dagger}, I. Bearzi3, F. Bianchi1, S. Sabato3, A. Mandolesi3, L. Belvederesi1, S. Cascinu2, N. Valeri4 and R. Cellerino1

1 Centro Regionale di Genetica Oncologica-Oncologia Medica, Università Politecnica delle Marche
2 Clinica di Oncologia Medica, Ospedali Riuniti Ancona
3 Anatomia ed Istologia Patologica
4 Scuola di Specializzazione in Oncologia, Università Politecnica delle Marche, Ancona, Italy

* Correspondence to: Dr C. Braconi, Centro Regionale di Genetica Oncologica-Oncologia Medica, Istituto di Medicina Clinica e Biotecnologie Applicate, Università Politecnica delle Marche, Via Tronto 1, 60100 Ancona, Italy. Tel: +39 0712206151; Fax: +39 0712206191; E-mail: chiarabraconi{at}tiscali.it

Background: The expression of the insulin-like growth factor (IGF) system has never been studied in gastrointestinal stromal tumors (GISTs).

Patients and methods: We studied the immunohistochemical expression of IGF1 receptor (IGFR-I), IGF1 and IGF2 in 94 samples of GISTs. IGF1 and IGF2 expression was scored in three classes: negative (N), moderate (M) and strong (S), according to staining intensity and extent.

Results: IGFR-I was overexpressed in all cases. IGF1 and IGF2 expression was absent in 25 and 48 cases, moderate in 29 and 16 cases and strong in 40 and 30 cases, respectively. Strong IGF1 expression significantly correlated with higher mitotic index (P = 0.0001), larger (P = 0.01), higher risk (P = 0.0002), metastatic (P = 0.0001) and relapsed (P = 0.04) GISTs. Strong IGF2 expression correlated with higher mitotic index (P = 0.05) and higher risk GISTs (P = 0.001). The Kaplan–Meier analysis (N versus M versus S) showed a significant worsening of the disease-free survival (DFS) with the increase of IGF1 (P = 0.02) and IGF2 (P = 0.02) expression. In the subgroup of patients with operated high-risk GISTs, there was a better trend in DFS for patients affected by GISTs with negative IGF1 and IGF2.

Conclusions: The expression of IGF1 and IGF2 seems to predict relapse in GIST patients.

Key words: GIST, IGF1, IGF2

{dagger} These authors have contributed equally to the work.

Received for publication October 19, 2007. Revision received January 24, 2008. Accepted for publication January 25, 2008.


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