Gershtein E.S., Nikolaev A.A., Korotkova E.A., Delektorskaya V.V., Kushlinskii N.E.

Introduction. Insulin-like growth factor (IGF) signaling system plays a major role in development and progression of various malignant tumors including colorectal cancer (CRC), so far its components are considered as potential diagnostic and prognostic markers and objects of molecular targeted therapy. Aim of the study. Analysis of the associations between pre-treatment blood serum content of IGF-I, II, and IGF-binding proteins (IGFBP)-1,2 and 3 and the overall survival rate of CRC patients, and evaluation of potential clinical relevance of these markers in CRC. Materials and methods. IGF-I, II, IGFBP-1, 2 and 3 blood serum levels were measured with standard ELISA kits (Mediagnost) in 95 CRC patients and 47 practically healthy persons. Results. In CRC patients the serum IGF-I and IGFBP-2 content was significantly higher, and IGFBP-3 content – lower than in the control group. A diagnostic complex for CRC enclosing these 3 markers was proposed, its sensitivity comprised 95%, specificity in relation to healthy control – 84%. Unfavorable effect of high pre-treatment levels of IGFBP-2 (700 ng/ml and more) and IGFBP-1 (4,5 ng/ml and more) and low levels of IGF-I (less than 110 ng/ml) on the overall survival of CRC patients was demonstrated. It was mostly pronounced in stage III-IV patients. IGF-I and IGRB-2 levels retain independent predictive value in multivariate analysis including TNM criteria of CRC dissemination.Conclusion. IGF system components play important role not only in CRC etiology and pathogenesis, but also in its clinical course. Hence, they deserve further evaluation as prognostic and diagnostic markers of this severe disease. The most promising prognostic marker appears to be IGFBP-2.
IGF-I, IGF-II, IGFBP-1, IGFBP-2, IGFBP-3, colorectal cancer

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