Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, China.
Precision Medicine Research Center, Shantou University Medical College, Shantou, China.
Gut Liver. 2020 Nov 15;14(6):727-734. doi: 10.5009/gnl19135.
BACKGROUND/AIMS: Esophagogastric junction adenocarcinoma (EJA) is a malignant tumor associated with high morbidity and has attracted increasing attention due to a rising incidence and low survival rate. Pathological biopsy is the gold standard for diagnosis, but noninvasive and effective tests are lacking, resulting in diagnoses at advanced stages. This study explored the diagnostic value of insulin-like growth factor binding protein 7 (IGFBP7) in EJA.
A total of 120 EJA patients and 88 normal controls were recruited, and their serum levels of IGFBP7 were measured by enzymelinked immunosorbent assay. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic value, and Pearson chi-square analysis was used to evaluate the correlation between IGFBP7 and clinical parameters. Kaplan- Meier survival analysis was carried out to assess the effect of IGFBP7 on overall survival (OS).
The levels of IGFBP7 were higher in both early- and late-stage EJA patients than in normal controls (p<0.001). The area under the ROC curve for EJA patients was 0.794 (95% confidence interval [CI], 0.733 to 0.854), with a cutoff value of 2.716 ng/mL, a sensitivity of 63.3% (95% CI, 54.0% to 71.8%) and a specificity of 90.9% (95% CI, 82.4% to 95.7%). For the diagnosis of early-stage EJA, the same cutoff value and specificity were obtained, but the sensitivity of IGFBP7 was 54.3% (95% CI, 36.9% to 70.8%). Patients with low IGFBP7 protein expression had lower OS than those with high expression (p=0.034). The multivariate analysis showed that IGFBP7 is an independent prognostic factor for EJA (p=0.011).
Serum IGFBP7 acts as a potential diagnostic and prognostic marker for EJA.
背景/目的：食管胃结合部腺癌（EJA）是一种与高发病率相关的恶性肿瘤，由于发病率上升和生存率低，越来越受到关注。病理活检是诊断的金标准，但缺乏非侵入性和有效的检测方法，导致诊断处于晚期。本研究探讨了胰岛素样生长因子结合蛋白 7（IGFBP7）在 EJA 中的诊断价值。
共招募了 120 例 EJA 患者和 88 例正常对照者，采用酶联免疫吸附试验检测血清 IGFBP7 水平。采用受试者工作特征（ROC）曲线分析评估诊断价值，采用 Pearson χ2 检验分析 IGFBP7 与临床参数的相关性。采用 Kaplan-Meier 生存分析评估 IGFBP7 对总生存期（OS）的影响。
早期和晚期 EJA 患者的 IGFBP7 水平均高于正常对照组（p<0.001）。EJA 患者的 ROC 曲线下面积为 0.794（95%置信区间 [CI]，0.733 至 0.854），截断值为 2.716ng/mL，灵敏度为 63.3%（95% CI，54.0%至 71.8%），特异性为 90.9%（95% CI，82.4%至 95.7%）。对于早期 EJA 的诊断，获得了相同的截断值和特异性，但 IGFBP7 的灵敏度为 54.3%（95% CI，36.9%至 70.8%）。低 IGFBP7 蛋白表达的患者的 OS 低于高表达的患者（p=0.034）。多因素分析显示，IGFBP7 是 EJA 的独立预后因素（p=0.011）。
血清 IGFBP7 可作为 EJA 的潜在诊断和预后标志物。
