Plasma Insulin-Like Growth Factor-Binding Protein-2 Levels as Diagnostic and Prognostic Biomarker of Colorectal Cancer
Plasma Insulin-Like Growth Factor-Binding Protein-2 Levels as Diagnostic and Prognostic Biomarker of Colorectal Cancer
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DOI：
10.1210/jc.2009-2668
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发表时间：
2010-04-01
影响因子：
5.8
通讯作者：
Lin, Jaw-Town
中科院分区：
文献类型：
--
作者：
Liou, Jyh-Ming;Shun, Chia-Tung;Lin, Jaw-Town
内容：IGF-II和IGF-binding protein（IGFBP）-2的过表达在几种癌症中均有报道。目的：我们旨在评估血浆IGF-II和IGFBP-2水平作为诊断和预后生物标志物的作用，以及IGF-II印迹缺失（LOI）对结直肠癌（CRC）生存率的影响。设计：我们进行了一项病例对照和前瞻性队列研究，分别用于诊断和预后价值。在162例CRC患者术前、15例根治性手术后配对患者、24例晚期结肠息肉患者、结果：以IGFBP-2为诊断指标的进展期结肠息肉和结直肠癌的曲线下面积分别为0.654 [95%可信区间（CI）= 0.547-0.76; P = 0.017]和0.815（95%CI = 0.766-0.864; P < 0.001）。以IGFBP-2 377 ng/ml为界值，诊断结直肠癌的敏感性为80.2%，特异性为64%。在多变量考克斯比例风险回归模型中，较高的IGFBP-2水平与死亡风险增加相关[风险比（HR）= 2.46; P = 0.017]，而较高的IGF-II水平与死亡风险降低相关（HR = 0.42; P = 0.044）。IGF-II的LOI与IV期结直肠癌患者的死亡风险增加相关（HR = 7.91; P = 0.014）。结论：IGFBP-2是结直肠癌潜在的诊断和预后生物标志物。IGF-II的LOI与IV期疾病患者的不良预后显著相关。（临床内分泌代谢杂志95：1717-1725，2010）
Context: Overexpression of IGF-II and IGF-binding protein (IGFBP)-2 has been reported in several cancers.Objective: We aimed to assess the roles of plasma IGF-II and IGFBP-2 levels as diagnostic and prognostic biomarkers and the impact of loss of imprinting (LOI) of IGF-II on the survival of colorectal cancer (CRC).Design: We conducted a case control and prospective cohort study for diagnostic and prognostic values, respectively.Patients and Setting: Plasma levels of IGF-II and IGFBP-2 were measured in 162 patients with CRC before surgery, in paired 15 patients after curative surgery, in 24 patients with advanced colon polyps, and in 114 healthy controls between 2003 and 2006 in National Taiwan University Hospital.Results: The area under the curve values of using IGFBP-2 as a diagnostic marker for advanced colon polyp and CRC were 0.654 [95% confidence interval (CI) = 0.547-0.76; P = 0.017] and 0.815 (95% CI = 0.766-0.864; P < 0.001), respectively. The sensitivity and specificity for diagnosing CRC were 80.2 and 64%, respectively, if the cutoff value of IGFBP-2 was 377 ng/ml. In the multivariate Cox proportional hazards regression model, higher IGFBP-2 levels were associated with increased risk of mortality [hazard ratio (HR) = 2.46; P = 0.017], whereas higher IGF-II levels were associated with reduced risk of mortality (HR = 0.42; P = 0.044). LOI of IGF-II was associated with increased risk of mortality (HR = 7.91; P = 0.014) in patients with stage IV disease.Conclusions: IGFBP-2 is a potential diagnostic and prognostic biomarker of CRC. LOI of IGF-II is significantly associated with poor prognosis in patients with stage IV disease. (J Clin Endocrinol Metab 95: 1717-1725, 2010)