Serum levels of insulin-like growth factor I (IGF-I), IGF-II, IGF-binding protein-3, and prostate-specific antigen as predictors of clinical prostate cancer.
Serum levels of insulin-like growth factor I (IGF-I), IGF-II, IGF-binding protein-3, and prostate-specific antigen as predictors of clinical prostate cancer.
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DOI：
10.1210/jcem.85.11.6990
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发表时间：
2000-11
期刊：
影响因子：
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通讯作者：
S. Harman;E. Metter;M. Blackman;P. Landis;H. Carter;Urology;Mitchell S Harman
中科院分区：
文献类型：
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作者：
S. Harman;E. Metter;M. Blackman;P. Landis;H. Carter;Urology;Mitchell S Harman
胰岛素样生长因子(IGF)可能在前列腺生长、增生和恶性肿瘤中发挥作用。高水平的血浆IGF-I与前列腺癌风险增加有关。在巴尔的摩老龄人口纵向研究中的一项前瞻性队列病例对照研究中，我们通过磁共振成像检查了前列腺体积，并在前列腺癌确诊前约9年获取了血清中的前列腺特异性抗原(PSA)、IGF-I、IGF-II和IGF结合蛋白-3(IGFBP-3)，其中72例患者或年龄匹配的对照组(n=127)，以及另外76例测量了前列腺癌体积并未患前列腺癌的巴尔的摩老年男性(正常受试者)。我们通过Logistic回归计算调整后的优势比(OR)，显著OR的相对风险，以及前列腺癌的受试者操作曲线，单独使用血清测量和联合使用。高与低三分位数的调整OR分别为：IGF-I，3.1[可信区间(CI)1.1-8.7]；IGF-II，0.2(CI，0.07-0.6)；IGFBP-3，0.71(CI，0.3-1.7)；PSA，12.5(CI，3.8-40.9)。对于显著的OR，IGF-I、IGF-II和PSA的相对风险估计仍然显著，分别为2.0、0.3和5.5。受试者操作员曲线显示PSA是前列腺癌最有效的预测指标。在PSA中加入IGF-II可以提高预测效果。胰岛素样生长因子-II与前列腺体积呈显著负相关(r=-0.219；P<0.01)，前列腺特异性抗原与前列腺体积呈正相关(r=0.461；P<；0.0001)，而胰岛素样生长因子-I和胰岛素样生长因子结合蛋白-3与前列腺体积无相关性。高IGF-I和低IGF-II独立地与前列腺癌风险增加相关，但PSA水平是一个比IGF-I或IGF-II更强的前列腺癌预测因子。缺乏IGF-I与前列腺大小的关系，与前列腺肥大的男性的确证增加是不一致的，因为前列腺大是与IGF-I相关的更高前列腺癌风险的来源。我们的数据表明，IGF-II可能同时抑制前列腺癌的生长和发展。
Insulin-like growth factors (IGFs) may play a role in prostate growth, hyperplasia, and malignancy. High plasma IGF-I has been associated with increased prostate cancer risk. In a prospective, cohort, case-control study in the Baltimore Longitudinal Study on Aging population, we examined prostate volume by magnetic resonance imaging, and prostate-specific antigen (PSA), IGF-I, IGF-II, and IGF-binding protein-3 (IGFBP-3) in sera obtained approximately 9 yr before diagnosis of prostate cancer in cases (n = 72) or age-matched controls (n = 127) and in 76 additional Baltimore Longitudinal Study on Aging men (normal subjects) with measured prostate volumes and no prostate cancer. We calculated adjusted odds ratios (OR) by logistic regression, relative risks for significant ORs, and receiver operator curves for prostate cancer, using serum measures alone and in combination. Adjusted ORs for the high vs. low tertile were: for IGF-I, 3.1 [confidence interval (CI), 1.1-8.7]; for IGF-II, 0.2 (CI, 0.07-0.6); for IGFBP-3, 0.71 (CI, 0.3-1.7); and for PSA, 12.5 (CI, 3.8-40.9). For significant ORs, relative risk estimates remained significant at 2.0 for IGF-I, 0.3 for IGF-II, and 5.5 for PSA. Receiver operator curves showed PSA to be the most powerful predictor of prostate cancer. Adding IGF-II to PSA improved prediction. IGF-II was significantly and inversely related (r = -0.219; P < 0.01) and PSA was directly and significantly related (r = 0.461; P < 0.0001) to prostate volume, whereas IGF-I and IBFBP-3 were not. High IGF-I and low IGF-II are independently associated with increased risk of prostate cancer, but PSA level is a much stronger predictor of prostate cancer in the ensuing 10 yr than either IGF-I or IGF-II. The absence of a relationship of IGF-I to prostate size is inconsistent with increased ascertainment in men with large prostates as the source of greater prostate cancer risk associated with IGF-I. Our data suggest that IGF-II may inhibit both prostate growth and development of prostate cancer.