Department of Nutritional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Nutr Cancer. 2020;72(5):858-863. doi: 10.1080/01635581.2019.1656755. Epub 2019 Sep 5.
This study aimed to analyze and evaluate serum insulin-like growth factor-binding protein 2 (IGFBP2) levels as a new biomarker of severe malnutrition in patients with advanced lung cancer. This prospective study involved 59 patients with advanced lung cancer. We detected serum IGFBP2 level by using enzyme-linked immunosorbent assay and analyzed its relationship to clinical characteristics, nutritional status, Glasgow prognostic score (GPS), and survival. Serum albumin and C-reactive protein (CRP) levels were measured, and nutritional status was assessed using Patient-Generated Subjective Global Assessment (PG-SGA). The best cutoff point value for serum IGFBP2 level was established using receiver operating characteristic analysis. Kaplan-Meier method was utilized to analyze the survival curves. Serum IGFBP2 levels were elevated in patients with advanced lung cancer and severe malnutrition. The best cutoff value for serum IGFBP2 level was determined at 363 ng/ml, which could diagnose severe malnutrition with 73.3% sensitivity and 70.5% specificity and was found to be related to albumin, CRP, and GPS. Patients whose serum IGFBP2 levels were higher than 363 ng/ml had poor survival outcome. This study demonstrates the remarkably association between higher serum level of IGFBP2 and severe malnutrition, albumin, CRP, GPS, and survival. Hence, serum IGFBP2 level can be used as a potential biomarker for diagnosis of severe malnutrition in patients with advanced lung cancer.
本研究旨在分析和评估血清胰岛素样生长因子结合蛋白 2(IGFBP2)水平作为晚期肺癌患者严重营养不良的新生物标志物。这项前瞻性研究共纳入 59 例晚期肺癌患者。我们通过酶联免疫吸附试验检测血清 IGFBP2 水平,并分析其与临床特征、营养状况、格拉斯哥预后评分(GPS)和生存的关系。同时,我们还检测了血清白蛋白和 C 反应蛋白(CRP)水平,并使用患者自评主观整体评估(PG-SGA)评估营养状况。采用受试者工作特征(ROC)曲线分析确定血清 IGFBP2 水平的最佳截断值。Kaplan-Meier 法用于分析生存曲线。结果发现,晚期肺癌患者的血清 IGFBP2 水平升高,且存在严重营养不良。血清 IGFBP2 水平的最佳截断值为 363ng/ml,其诊断严重营养不良的灵敏度为 73.3%,特异度为 70.5%,且与白蛋白、CRP 和 GPS 相关。血清 IGFBP2 水平高于 363ng/ml 的患者生存预后较差。本研究表明,血清 IGFBP2 水平与严重营养不良、白蛋白、CRP、GPS 和生存之间存在显著关联。因此,血清 IGFBP2 水平可作为诊断晚期肺癌患者严重营养不良的潜在生物标志物。