Background/Objectives: Insulin-like growth factor-1 receptor (IGF-1R) displays a key role in tumor transformation and metastasis. It also makes tumor cells more resistant to chemotherapy. The aim of this study was to investigate the correlation between IGF-1R and multidrug resistance-associated protein-1 (MRP-1), and the clinical significance of their expression in gastric carcinoma (GC). Methods: IGF-1R and MRP-1 expressed in 113 specimens were detected by immunohistochemistry. The correlation between IGF-1R and MRP-1 expression was determined. In addition, the association of their expression with clinicopathological features and survival data of GC was also analyzed. Results: IGF-1R (75.2%) and MRP-1 (69.0%) were frequently expressed in GC. IGF-1R was associated with tumor size, quantity of stroma, depth of wall invasion, lymph node metastasis, TNM stages and differentiation status of GC (p < 0.05). MRP-1 was associated with tumor size, quantity of stroma, lymph node metastasis, distant metastasis and TNM stages (p < 0.05). IGF-1R over-expression positively correlated with MRP-1 over-expression (rp = 0.39, p < 0.01). IGF-1R and MPR-1 over-expression were correlated with poor prognosis of GC (p < 0.01). 102 patients receiving adjuvant FOLFOX-4 chemotherapy who co-expressed IGF-1R/MRP-1 had poor prognosis (p < 0.05). Conclusions: The levels of co-expression of IGF-1R/MRP-1 in GC may predict the therapeutic effect of chemotherapy and prognosis of GC.

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