血清胰岛素样生长因子I/游离前列腺特异性抗原（IGF-I/fPSA）比值可提高总前列腺特异性抗原（PSA）水平在4.0 - 10.0 ng/ml的男性前列腺癌的检测率。

Serum insulin-like growth factor I/free prostate specific antigen (IGF-I/fPSA) ratio enhances prostate cancer detection in men with total PSA 4.0-10.0 ng/ml.

作者信息

Zhigang Zhao, Jieming Liu, Su Li, Wenlu Shen

机构信息

Department of Urology, The Second Affiliated Hospital, Shantou University Medical, College, Shantou, Guangdong Province, China.

出版信息

J Surg Oncol. 2007 Jul 1;96(1):54-61. doi: 10.1002/jso.20784.

DOI:10.1002/jso.20784

PMID:17345593

Abstract

BACKGROUND

Recent studies have suggested that IGF-I and IGFBP-3, in combination with PSA, may enhance PCa detection. This study was to investigate the use of serum IGF-I and IGFBP-3, and their combinations with prostate volume and fPSA in enhancing the discriminatory diagnosis of PCa in men with tPSA of 4.0-10.0 ng/ml.

METHODS

Serum IGF-I and IGFBP-3 were determined by ELISA from 586 men with tPSA between 4.0 and 10.0 ng/ml. Of them, 281 were diagnosed with PCa and 305 without. ROC, univariate and multivariate logistic regression analyses were performed to evaluate the predictive performance of those parameters.

RESULTS

IGF-I, IGFD, IGF-I/fPSA, and IGFBP-3/fPSA were significantly higher in PCa cases than benign controls, whereas the differences of IGFBP-3 and IGFBPD were statistically insignificant between the two groups, respectively. The AUC values indicated enhanced performance of IGF-I/fPSA ratio (AUC = 0.753) in PCa detection compared with the currently used f/tPSA (AUC = 0.689). Multivariate logistic regression confirmed the observed relationships and identified IGF-I/fPSA as independent factor in PCa presence.

CONCLUSION

Our data show that IGF-I/fPSA as a promising marker can enhance PCa detection in ambiguous cases often found in the tPSA between 4.0 and 10.0 ng/ml.

摘要

背景

近期研究表明，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）与前列腺特异性抗原（PSA）联合使用，可能会提高前列腺癌（PCa）的检测率。本研究旨在探讨血清IGF-I和IGFBP-3及其与前列腺体积和游离PSA（fPSA）的组合，在提高总PSA（tPSA）为4.0 - 10.0 ng/ml男性的PCa鉴别诊断中的应用。

方法

采用酶联免疫吸附测定法（ELISA）测定了586例tPSA在4.0至10.0 ng/ml之间男性的血清IGF-I和IGFBP-3。其中，281例被诊断为PCa，305例未患PCa。进行了受试者工作特征曲线（ROC）、单因素和多因素逻辑回归分析，以评估这些参数的预测性能。

结果

PCa患者的IGF-I、IGFD、IGF-I/fPSA和IGFBP-3/fPSA显著高于良性对照组，而两组之间IGFBP-3和IGFBPD的差异分别无统计学意义。AUC值表明，与目前使用的f/tPSA（AUC = 0.689）相比，IGF-I/fPSA比值在PCa检测中的性能有所提高（AUC = 0.753）。多因素逻辑回归证实了观察到的关系，并确定IGF-I/fPSA是PCa存在的独立因素。