胰岛素样生长因子-I（IGF-I）和胰岛素样生长因子结合蛋白-3（IGFBP-3）的循环浓度不能预测小儿骨肉瘤的发病率或临床行为。

Circulating concentrations of IGF-I and IGFBP-3 are not predictive of incidence or clinical behavior of pediatric osteosarcoma.

作者信息

Rodriguez-Galindo C, Poquette C A, Daw N C, Tan M, Meyer W H, Cleveland J L

机构信息

Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.

出版信息

Med Pediatr Oncol. 2001 Jun;36(6):605-11. doi: 10.1002/mpo.1137.

DOI:10.1002/mpo.1137

PMID:11344491

Abstract

BACKGROUND

Preclinical studies suggest a role of insulin-like growth factor-1 (IGF-1) in the proliferation of osteosarcoma cells in vivo. The purpose of this study is to address the relationship between serum levels of IGF-1 and its binding protein (IGFBP-3), and the clinical behavior and outcome of osteosarcoma in children, and to compare those levels present in osteosarcoma patients with a normal population.

PROCEDURE

Serum IGF-1 and IGFBP-3 levels were determined by ELISA in 37 patients with osteosarcoma treated on the same treatment regimen (OS-91 protocol), and who had available serum samples from diagnosis. IGF-1 and IGFBP-3 levels were compared with those previously established in the normal population, matched for age and gender, and were correlated with the presence of metastatic disease, histologic response to preoperative chemotherapy, and event-free survival.

RESULTS

In osteosarcoma patients the median IGF-1 level was 275 ng/ml (range, 105-613) and the median IGFBP-3 level was 3.4 mg/L (range, 2.3-5.1). IGF-1 levels differed from those in the normal population (P = 0.029); although we anticipated higher IGF-1 levels than normal children, 68% of observed standardized scores were less than 0. Furthermore, IGF-1 or IGFBP-3 levels failed to correlate with the presence of metastatic disease (P = 0.12 and P = 0.12, respectively), histologic response (Rosen-Huvos grades 3/4 vs. grades 1/2) (P = 0.95 and P = 0.71, respectively), or event-free survival (P = 0.52 and P = 0.41, respectively). There was a strong association observed between IGF-1 and IGFBP-3 levels (P < 0.001).

CONCLUSIONS

In this retrospective study of 37 patients, we found that circulating levels of IGF-1 and IGFBP-3 are not predictive of the development or clinical characteristics of pediatric osteosarcoma. However, further studies on a larger patient population should be performed in order to investigate this relationship.

摘要

背景

临床前研究表明胰岛素样生长因子-1（IGF-1）在骨肉瘤细胞的体内增殖中起作用。本研究的目的是探讨血清IGF-1及其结合蛋白（IGFBP-3）水平与儿童骨肉瘤的临床行为及预后之间的关系，并将骨肉瘤患者的这些水平与正常人群进行比较。

方法

采用酶联免疫吸附测定法（ELISA）测定37例接受相同治疗方案（OS-91方案）治疗且从诊断时起有可用血清样本的骨肉瘤患者的血清IGF-1和IGFBP-3水平。将IGF-1和IGFBP-3水平与先前在年龄和性别匹配的正常人群中确定的水平进行比较，并与转移性疾病的存在、术前化疗的组织学反应以及无事件生存期相关联。

结果

骨肉瘤患者的IGF-1水平中位数为275 ng/ml（范围为105 - 613），IGFBP-3水平中位数为3.4 mg/L（范围为2.3 - 5.1）。IGF-1水平与正常人群不同（P = 0.029）；尽管我们预期IGF-1水平高于正常儿童，但68%的观察标准化分数小于0。此外，IGF-1或IGFBP-3水平与转移性疾病的存在（分别为P = 0.12和P = 0.12）、组织学反应（罗森-胡沃斯分级3/4级与1/2级）（分别为P = 0.95和P = 0.71）或无事件生存期（分别为P = 0.52和P = 0.41）均无相关性。IGF-1和IGFBP-3水平之间观察到强关联（P < 0.001）。