Abstract

Insulin-like growth factors (IGFs) play an important role in normal cellular growth and development and have been implicated in the regulation of tumour growth. Two receptors are recognized, IGFR-1 and IGFR-2, of which one, IGFR-1, is a transmembrane heterodimer structurally similar to the insulin receptor. Studies using ligand-binding assays have suggested that the proportion of human breast carcinomas expressing IGFR-1 varies between 39 and 93 per cent and all suggest a lower level of IGFR-1 expression in benign mammary epithelia. As there is this variation between studies and since no study appears to have examined the immunohistochemical localization of IGFR-1 within breast tissue, a series of 79 infiltrating ductal carcinomas, 11 infiltrating lobular carcinomas, three cases of pure ductal carcinoma in situ (DCIS), seven fibroadenomas, and eight normal breast specimens have been studied utilizing the monoclonal antibody alpha IR3. IGFR-1 localized to the epithelial component of 90 per cent of the carcinomas, with only cytoplasmic (21 per cent), only membrane (5 per cent), or a mixture of both cytoplasmic and membrane (64 per cent) staining patterns. In some tumours, distinct basolateral distribution of the receptor was observed. Invasive lobular carcinoma showed significantly less labelling than ductal (P = 0.0009). There was a significant correlation between the level of IGFR-1 immunostaining with both oestrogen receptor (P < 0.001) and progesterone receptor (P = 0.0018) positivity within the malignant group. All normal mammary epithelium showed strong labelling, which was often at an intensity matching that of the most strongly labelled carcinoma and occasionally visualized as basolateral staining of the luminal cells. Weak to moderate staining of endothelial cells was also observed. It is concluded that IGFR-1 immunoreactivity is found in the majority of breast carcinomas, where it correlates most closely with oestrogen receptor status. The high intensity labelling of normal cells seen in this study contrasts with the low levels inferred from ligand-binding-based techniques and emphasizes the importance of the morphological approach in the investigation of novel molecules.

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