Serum Insulin-like Growth Factor-I Level Is an Independent Predictor of Recurrence and Survival in Early Hepatocellular Carcinoma: A Prospective Cohort Study
Serum Insulin-like Growth Factor-I Level Is an Independent Predictor of Recurrence and Survival in Early Hepatocellular Carcinoma: A Prospective Cohort Study
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DOI：
10.1158/1078-0432.ccr-12-3443
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发表时间：
2013-08-01
影响因子：
11.5
通讯作者：
Lee, Hyo-Suk
中科院分区：
文献类型：
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作者：
Cho, Eun Ju;Lee, Jeong-Hoon;Lee, Hyo-Suk
目的：胰岛素样生长因子-I（IGF-I）反映肝脏的合成功能，在多种肿瘤的发生、发展中起重要作用。在这项研究中，我们调查了治疗前血清IGF-I水平是否能预测早期肝细胞癌患者治愈性治疗后的复发时间（TTR）和总生存期（OS）。接受过手术切除、射频消融、或经皮无水乙醇注射作为早期肝细胞癌的治愈性治疗，包括从两个前瞻性队列和训练集（n = 10）。101）和验证集（n = 91）。在治疗前收集血清样本，分析IGF-I和IGF-binding protein-3（IGFBP-3）水平与复发和生存率的关系。在52.4个月的中位随访期内，IGF-I水平高的患者（中位数，50.8个月; 95%CI，36.9-64.7; P < 0.001）的平均IGF-I水平高的患者（中位数，50.8个月; 95%CI，1.8-27.5）。在多因素分析中，低水平IGF-I是复发的独立预测因子（HR，2.49; 95% CI，1.52-4.08; P < 0.001）。此外，与高血清甲胎蛋白和多发性肿瘤一起，低水平IGF-I仍然是生存率较差的独立预测因子（HR，8.00; 95%CI，1.94-33.01; P = 0.004）。应用于独立验证集，低血清IGF-I水平保持其预后价值较短的TTR和OS.Conclusions：低基线IGF-I水平独立相关的TTR较短，生存率较差的早期肝细胞癌根治性治疗后的患者。(C)2013年AACR。
Purpose: Insulin-like growth factor-I (IGF-I) reflects hepatic synthetic function and plays an important role in the development and progression of various cancers. In this study, we investigated whether pretreatment serum IGF-I levels predict time-to-recurrence (TTR) and overall survival (OS) in patients with early-stage hepatocellular carcinoma after curative treatment.Experimental Design: Consecutive patients with hepatocellular carcinoma who had undergone surgical resection, radiofrequency ablation, or percutaneous ethanol injection as curative treatments of early hepatocellular carcinoma were included from two prospective cohorts and the training set (n = 101) and the validation set (n = 91) were established. Serum samples were collected before treatment and the levels of IGF-I and IGF-binding protein-3 (IGFBP-3) were analyzed with regard to their associations with recurrence and survival.Results: In the training set, patients with low IGF-I levels showed significantly shorter TTR [median, 14.6 months; 95% confidence interval (CI), 1.8-27.5] than patients with high IGF-I levels (median, 50.8 months; 95% CI, 36.9-64.7; P < 0.001) during a median follow-up period of 52.4 months. In the multivariate analysis, low levels of IGF-I were an independent predictor of recurrence (HR, 2.49; 95% CI, 1.52-4.08; P < 0.001). Furthermore, together with high-serum alpha-fetoprotein and multiple tumors, low levels of IGF-I remained an independent predictor of poorer survival (HR, 8.00; 95% CI, 1.94-33.01; P = 0.004). Applied to the independent validation set, low-serum IGF-I levels maintained their prognostic value for shorter TTR and OS.Conclusions: Low-baseline IGF-I levels independently correlated with shorter TTR and poorer survival in patients with early-stage hepatocellular carcinoma after curative treatment. (C) 2013 AACR.