Serin Ibrahim Serdar, Tanriverdi Fatih, Yilmaz Mustafa Oguz, Ozcelik Bulent, Unluhizarci Kursad
Department of Obstetrics and Gynecology, Erciyes University Medical Faculty, Kayseri, Turkey.
Gynecol Endocrinol. 2008 Mar;24(3):117-21. doi: 10.1080/09513590801895559.
The aims of the present study were to determine the serum concentrations of insulin-like growth factor-I (IGF-I), insulin-like growth factor binding protein-3 (IGFBP-3) and leptin and insulin resistance in benign and malignant epithelial ovarian tumors, and to discuss the use of these markers in benign-malignant tumor differentiation.
Forty-seven postmenopausal women with ovarian tumor and 31 age-matched, postmenopausal, healthy controls were included in this study. Insulin resistance index by homeostasis model assessment (HOMA score) and fasting blood glucose (FBG), serum IGF-I, IGFBP-3, leptin and CA-125 concentrations were determined in all patients preoperatively. The results were evaluated according to postoperative histopathology results.
According to postoperative histopathology results, the patients were divided into malignant (n = 23), benign (n = 24) and control (n = 31) groups. There were no differences among the groups in relation to age, body mass index, FBG and HOMA score (p > 0.05). Serum concentrations of CA-125 were elevated in the malignant group compared with the benign ovarian tumor and control groups (p < 0.05). In contrast, serum IGF-I concentrations were significantly decreased in patients with malignant and benign ovarian tumors compared with controls (p < 0.05). Serum IGFBP-3 concentrations were also found to be lower in women with malignant ovarian tumors than in women with benign tumors (p < 0.05). Serum leptin did not differ among patients with malignant-benign tumors and controls (p > 0.05).
Serum leptin and HOMA score have not been found to be valid indicators in ovarian tumors. However, the present data suggest that low concentrations of IGF-I and IGFBP-3 could be a reliable marker to differentiate benign from malignant ovarian tumors. Further experimental studies are warranted to understand the impact of the IGF-I system in ovarian carcinogenesis.
本研究旨在测定良性和恶性上皮性卵巢肿瘤患者血清中胰岛素样生长因子-I(IGF-I)、胰岛素样生长因子结合蛋白-3(IGFBP-3)、瘦素水平及胰岛素抵抗情况,并探讨这些标志物在卵巢良恶性肿瘤鉴别诊断中的应用。
本研究纳入47例绝经后卵巢肿瘤患者及31例年龄匹配的绝经后健康对照者。术前测定所有患者的稳态模型评估胰岛素抵抗指数(HOMA评分)、空腹血糖(FBG)、血清IGF-I、IGFBP-3、瘦素及CA-125浓度。根据术后组织病理学结果进行评估。
根据术后组织病理学结果,将患者分为恶性组(n = 23)、良性组(n = 24)和对照组(n = 31)。三组在年龄、体重指数、FBG及HOMA评分方面差异无统计学意义(p > 0.05)。与良性卵巢肿瘤组和对照组相比,恶性组血清CA-125浓度升高(p < 0.05)。相反,与对照组相比,恶性和良性卵巢肿瘤患者血清IGF-I浓度显著降低(p < 0.05)。恶性卵巢肿瘤患者血清IGFBP-3浓度也低于良性肿瘤患者(p < 0.05)。恶性和良性肿瘤患者与对照组血清瘦素水平差异无统计学意义(p > 0.05)。
血清瘦素和HOMA评分在卵巢肿瘤中并非有效的指标。然而,目前的数据表明,低浓度的IGF-I和IGFBP-3可能是鉴别卵巢良恶性肿瘤的可靠标志物。有必要进行进一步的实验研究以了解IGF-I系统在卵巢癌发生中的作用。