Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA.
Department of Anatomy and Cell Biology, Rush University Medical Center, Chicago, IL 60612, USA.
Oncotarget. 2022 Feb 18;13:393-407. doi: 10.18632/oncotarget.28202. eCollection 2022.
Detection rates of early-stage lung cancer are traditionally low, which contributes to inconsistent treatment responses and high rates of annual cancer deaths. Currently, low-dose computed tomography (LDCT) screening produces a high false discovery rate. This limitation has prompted research to identify biomarkers to more clearly define eligible patients for LDCT screening, differentiate indeterminate pulmonary nodules, and select individualized cancer therapy. Biomarkers within the Insulin-like Growth Factor (IGF) family have come to the forefront of this research. Main Body: Multiple biomarkers within the IGF family have been investigated, most notably IGF-I and IGF binding protein 3. However, newer studies seek to expand this search to other molecules within the IGF axis. Certain studies have demonstrated these biomarkers are useful when used in combination with lung cancer screening, but other findings were not as conclusive, possibly owing to measurement bias and non-standardized assay techniques. Research also has suggested IGF biomarkers may be beneficial in the prognostication and subsequent treatment via systemic therapy. Despite these advances, additional knowledge of complex regulatory mechanisms inherent to this system are necessary to more fully harness the potential clinical utility for diagnostic and therapeutic purposes.
The IGF system likely plays a role in multiple phases of lung cancer; however, there is a surplus of conflicting data, especially prior to development of the disease and during early stages of detection. IGF biomarkers may be valuable in the screening, prognosis, and treatment of lung cancer, though their exact application requires further study.
传统上，早期肺癌的检出率较低，这导致治疗反应不一致，癌症年死亡率较高。目前，低剂量计算机断层扫描（LDCT）筛查的假阳性率很高。这一局限性促使研究人员寻找生物标志物，以更明确地确定适合 LDCT 筛查的患者，区分不确定的肺结节，并选择个体化的癌症治疗方法。胰岛素样生长因子（IGF）家族内的生物标志物成为了这一研究的前沿领域。
IGF 家族内的多个生物标志物已被研究，其中最著名的是 IGF-I 和 IGF 结合蛋白 3。然而，新的研究试图将这一研究扩展到 IGF 轴内的其他分子。某些研究表明，这些生物标志物在与肺癌筛查联合使用时是有用的，但其他研究结果并不那么确定，这可能是由于测量偏差和非标准化检测技术。研究还表明，IGF 生物标志物可能在预测和随后的系统治疗中获益。尽管取得了这些进展，但仍需要更多关于该系统固有复杂调节机制的知识，以更充分地利用其在诊断和治疗方面的潜在临床应用价值。
IGF 系统可能在肺癌的多个阶段发挥作用；然而，存在大量相互矛盾的数据，尤其是在疾病发生之前和早期检测阶段。IGF 生物标志物在肺癌的筛查、预后和治疗中可能具有价值，但它们的确切应用需要进一步研究。
