Insulin‐like Growth Factor II in Gynecological Cancers: A Preliminary Study

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Abstract
PROBLEM: We have previously reported elevated serum levels of cervical human papilloma viral proteins E6 and E7 and serum insulin‐like growth factor II (IGF‐II) in women with cervical cancer and advanced cervical intraepithelial neoplasia. As most women with cervical cancer have elevated levels of serum IGF‐II, we sought to determine whether the cervical cancer and lymph node biopsies from these women demonstrated increased production of IGF‐II and whether this elevation was also present in ovarian and endometrial cancers.METHOD OF STUDY: We used the semi‐quantitative immunofluo‐ rescent antibody assay established in our laboratory to identify the levels of IGF‐II in 21 cervical cancers (seven with matching lymph nodes), 18 benign cervical biopsies, 13 endometrial cancers, 15 benign endometrial biopsies, 5 ovarian cancers, and 15 benign ovarian biopsies.RESULTS: The immunofluorescent IGF‐II levels (relative intensity per pixel) were the highest in cervical cancers; they were significantly higher than in matched controls. IGF‐II levels were not higher in ovarian cancers and only slightly elevated in endometrial cancers. The presence of IGF‐II in pelvic lymph nodes of women with cervical cancer paralleled with those in the cervical cancers. Interestingly, we could identify small nests of metastases of malignant cells in the nodes (pauci‐cellular metastasis) by using IGF‐II as the marker.CONCLUSION: We propose that measurement and identification of IGF‐II in the cervical biopsy may be a sensitive method of detecting cervical cancer and metastatic spread in the lymph nodes.

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