CLINICAL SIGNIFICANCE OF SERUM INSULIN-LIKE GROWTH FACTOR-1 (IGF-1) AND INSULIN- LIKE GROWTH BINDING PROTEIN-3 (IGFBP-3) IN PATIENTS WITH GASTRIC CANCER

SÜLEYMAN BADEMLER¹, MURAT SARI², MUHAMMET ZUBEYR ÜÇÜNCܳ, MURAT SERILMEZ⁴, SENEM KARABULUT²

¹Department of Surgery, Institute of Oncology, Istanbul University, Istanbul, Turkey - ²Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey - ³Department of General Surgery, Institute of Health Sciences, Istanbul Gelişim University, Istanbul, Turkey - ⁴Department of Basic Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey

Introduction: Early diagnosis reduces mortality in gastric adenocarcinoma (GC). However, there are no markers that can be used to allow early diagnosis. The aim of the present study was to investigate clinical utility of insulin-like growth factor-1 (IGF-1) and insulin-like growth-binding protein-3 (IGFBP-3) in the diagnosis of GC.

Materials and methods: Hundred and fifteen patients with histopathologically confirmed diagnosis of GC and 53 age- and sex-matched healthy controls were included in our study at Istanbul University Institute of Oncology. Serum IGF-1 and IGFBP-3 levels were determined using enzyme-linked immunosorbent assay (ELISA).

Results: The mean age of the patients was 61 (range: 32-89) years. At the end of the median 11-month follow-up period, 75% (n=86) of the patients died. Serum IGF-1 and IGFBP-3 levels were significantly lower in the patient group than those in the control group (p=0.001). The sensitivity and specificity for IGF-1 were found to be 62.61% and 68.52%, respectively. The sensi- tivity and specificity for IGFBP-3 were found to be 73.91% and 62.96%, respectively. Serum IGFBP-3 levels were significantly higher in younger patients compared to those in older patients (p=0.009). The median survival was 14±3.3 months (95% CI=7.6- 20.4). 3-year survival rate was 25.6% (95% CI=15.4-35.8). Large T status, high N status and metastasis were found to have a prognostic role on survival (p=0.05, p=0.05, and p=0.003, respectively). Serum IGF-1 and IGFBP-3 concentrations had no prog- nostic role on survival (p=0.72, p=0.41, respectively).

Conclusion: In our study, we showed that serum IGF-1 and IGFBP-3 levels could be used for early diagnosis of GC. We found that these two biomarkers have good sensitivity and specificity in clinical practice.