Department of Toxicology, Faculty of Pharmacy, Medical University, Lodz, Poland.
Clin Chem Lab Med. 2011 Oct;49(10):1699-705. doi: 10.1515/CCLM.2011.651. Epub 2011 Jun 15.
The objective of the present study is to explore the association between zinc concentrations and insulin-like growth factor 1 (IGF-1), its binding protein (IGFBP-3) and total prostate-specific antigen (tPSA) levels in the serum of patients with prostate cancer (PCa) and prostate intraepithelial neoplasia (PIN), a pre-cancer state matched for age.
The study was carried out in a group of 229 patients who had transurethral prostate biopsy performed. The patients were divided into three groups: control group (BPH), PIN group or PCa group. The patients had plasma zinc concentration determined by atomic absorption spectrometry; IGF-1, IGFBP-3 analyzed using the chemiluminescence method and tPSA detected in serum with DELFIA assay.
The studies revealed that, in PCa and PIN patients aged under 65 years, mean zinc concentrations were significantly lower compared with the control group. IGF-1 level significantly increased with decreasing level of zinc in plasma, hence a significantly decreased Zn/IGF-1 ratio. The mean tPSA concentration was significantly increased only in PCa patients of both age groups, whereas the Zn/tPSA ratio significantly decreased with increasing severity of neoplastic lesions, particularly in patients aged under 65 years. Statistical significance was noted for IGF-1:tPSA and IGFBP-3:tPSA ratios, being almost two-fold lower in the PCa patients than in the control group.
A significantly lowered Zn/tPSA ratio appears to be a sensitive marker of neoplastic lesions, PCa and PIN, regardless of age. In men under 65 years, the Zn/IGF-1 ratio was reduced, depending on the stage of neoplastic lesions (PIN>PCa). These finding can be useful in early diagnosis of prostate cancer.
本研究旨在探讨前列腺癌(PCa)和前列腺上皮内瘤变(PIN)患者血清中锌浓度与胰岛素样生长因子 1(IGF-1)、其结合蛋白(IGFBP-3)和总前列腺特异性抗原(tPSA)水平之间的关系,PIN 是一种癌前状态,与年龄匹配。
本研究共纳入 229 例接受经尿道前列腺活检的患者。患者分为三组:对照组(BPH)、PIN 组或 PCa 组。通过原子吸收光谱法测定患者血浆锌浓度;采用化学发光法分析 IGF-1、IGFBP-3,采用 DELFIA 法检测血清 tPSA。
研究发现,65 岁以下 PCa 和 PIN 患者的平均锌浓度明显低于对照组。随着血浆锌水平的降低,IGF-1 水平显著升高,导致 Zn/IGF-1 比值显著降低。仅在两组年龄的 PCa 患者中,平均 tPSA 浓度显著升高,而 Zn/tPSA 比值随着肿瘤病变严重程度的增加而显著降低,尤其是在 65 岁以下的患者中。IGF-1:tPSA 和 IGFBP-3:tPSA 比值具有统计学意义,PCa 患者的比值几乎是对照组的两倍。
Zn/tPSA 比值降低似乎是肿瘤病变、PCa 和 PIN 的敏感标志物,与年龄无关。在 65 岁以下的男性中,Zn/IGF-1 比值随着肿瘤病变的分期(PIN>PCa)而降低。这些发现可能有助于前列腺癌的早期诊断。