Department of Cellular and Molecular Biology and Pathology L. Califano, University of Naples Federico II, Naples, Italy.
Prostate. 2012 Jan;72(1):100-7. doi: 10.1002/pros.21411. Epub 2011 Apr 25.
About 43% of men with low Gleason grade prostate cancer (PCa) at biopsy will be finally diagnosed with high-grade PCa at radical prostatectomy (RP). Gleason sum at RP is a good indicator of biochemical recurrence and poor clinical outcome. Therefore, there is a need to improve clinical evaluation of PCa aggressiveness in order to choice appropriate treatment. To this aim an easy-available tool is represented by circulating biomarkers. Among these, the best candidates are some molecules involved in PCa pathogenesis such as IGFBP-2 and IGFBP-3, IL-6, and its soluble receptor (SIL-6R).
In this study, we evaluated the ability of preoperative IGFBP-2, IGFBP-3, IL-6, and SIL-6R serum levels to predict Gleason score upgrade in 52 PCa patients.
We found that IGFBP-3 median levels were significantly lower in patients who showed Gleason upgrading from biopsy to RP (P = 0.024). We also found an association between biopsy T-stage and Gleason Upgrade (P = 0.011). Using multivariate logistic regression model, we demonstrated that the association of IGFBP-3 serum levels together with biopsy T-stage and biopsy Gleason score was useful to calculate a prognostic risk score. ROC curve analysis of risk score showed a good ability to predict GSU (AUC = 0.81; 95% CI 0.69-0.93).
Our results suggest that preoperative IGFBP-3 circulating levels determination may be useful to predict Gleason score upgrading alone and/or in combination with biopsy T-stage and biopsy Gleason score.
大约 43% 在活检时被诊断为低格里森分级前列腺癌（PCa）的男性在根治性前列腺切除术后（RP）最终会被诊断为高级别 PCa。RP 时的格里森总和是生化复发和不良临床结局的良好指标。因此，需要改进 PCa 侵袭性的临床评估，以便选择适当的治疗方法。为此，一种易于获得的工具是循环生物标志物。在这些标志物中，最好的候选标志物是一些参与 PCa 发病机制的分子，如 IGFBP-2 和 IGFBP-3、IL-6 和其可溶性受体（SIL-6R）。
在这项研究中，我们评估了术前 IGFBP-2、IGFBP-3、IL-6 和 SIL-6R 血清水平预测 52 例 PCa 患者格里森评分升级的能力。
我们发现，在 RP 时出现格里森评分升级的患者中，IGFBP-3 的中位数水平显著降低（P=0.024）。我们还发现，活检 T 分期与格里森升级之间存在关联（P=0.011）。使用多变量逻辑回归模型，我们证明了 IGFBP-3 血清水平与活检 T 分期和活检格里森评分的联合与计算预后风险评分有关。风险评分的 ROC 曲线分析显示出良好的预测 GSU 能力（AUC=0.81；95%CI 0.69-0.93）。
我们的结果表明，术前 IGFBP-3 循环水平的测定可能有助于单独预测格里森评分升级，以及（或）与活检 T 分期和活检格里森评分联合预测。
