Xu Jie, Song Yuning, Zhou Bodong, Yuan Shuai, Gao Song
Senior Ward, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China.
Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China.
Open Med (Wars). 2024 Aug 30;19(1):20230893. doi: 10.1515/med-2023-0893. eCollection 2024.
Insulin-like growth factor binding protein 2 (IGFBP2) is overexpressed in tumor tissues of several malignancies, including pancreatic cancer. Because of its role in tumor progression, IGFBP2 has been investigated as a tumor biomarker. However, little is known about its utility in pancreatic cancer. Plasma IGFBP2 levels were determined using enzyme-linked immunosorbent assay in 75 patients with pancreatic ductal adenocarcinoma (PDAC), 73 matched healthy controls, and 17 chronic pancreatitis patients. Our results showed that the plasma IGFPB2 level was significantly higher in PDAC patients than in patients with chronic pancreatitis and healthy controls. At a cut-off value of 333.9 ng/mL, the specificity and sensitivity were 78.08 and 65.33%, respectively. IGFBP2 level alone did not outperform carbohydrate antigen 19-9 (CA19-9) in diagnostic accuracy, but it successfully identified 9 out of 24 PDAC patients who were misidentified by CA19-9. The combination of IGFBP2 and CA19-9 was more accurate in the detection of PDAC than CA19-9 alone. IGFBP2 was more accurate than the other in discriminating between chronic pancreatitis and PDAC. Plasma IGFBP2, rather than CA19-9, was higher in the new-onset diabetes, lymph node involvement, and distant metastasis subgroups. IGFBP2 level was notably higher in stage IV cases than in stage I/II or stage III disease. However, CA19-9 did not show a difference between stages. After adjusting for lymph node involvement and distant metastasis, plasma IGFBP2 was identified as an independent prognostic marker for PDAC. The median survival time for patients with an IGFBP2 level ≥333.9 ng/mL was significantly shorter than that for patients with an IGFBP2 level <333.9 ng/mL. Marked elevation of plasma IGFBP2 in PDAC is associated with poorer survival. IGFBP2 may be considered as a supplementary biomarker for the diagnosis and prognostic prediction in Chinese pancreatic cancer patients.
胰岛素样生长因子结合蛋白2（IGFBP2）在包括胰腺癌在内的多种恶性肿瘤的肿瘤组织中过表达。由于其在肿瘤进展中的作用，IGFBP2已被作为一种肿瘤生物标志物进行研究。然而，关于其在胰腺癌中的应用知之甚少。采用酶联免疫吸附测定法测定了75例胰腺导管腺癌（PDAC）患者、73例匹配的健康对照者和17例慢性胰腺炎患者的血浆IGFBP2水平。我们的结果显示，PDAC患者的血浆IGFPB2水平显著高于慢性胰腺炎患者和健康对照者。在临界值为333.9 ng/mL时，特异性和敏感性分别为78.08%和65.33%。单独的IGFBP2水平在诊断准确性方面并不优于糖类抗原19-9（CA19-9），但它成功地识别出了24例被CA19-9误诊的PDAC患者中的9例。IGFBP2和CA19-9联合检测PDAC比单独检测CA19-9更准确。在区分慢性胰腺炎和PDAC方面，IGFBP2比其他指标更准确。在新发糖尿病、淋巴结受累和远处转移亚组中，血浆IGFBP2而非CA19-9更高。IV期病例的IGFBP2水平明显高于I/II期或III期疾病。然而，CA19-9在各阶段之间没有差异。在调整淋巴结受累和远处转移因素后，血浆IGFBP2被确定为PDAC的独立预后标志物。IGFBP2水平≥333.9 ng/mL的患者的中位生存时间显著短于IGFBP2水平<333.9 ng/mL的患者。PDAC患者血浆IGFBP2的显著升高与较差的生存率相关。IGFBP2可被视为中国胰腺癌患者诊断和预后预测的补充生物标志物。
