Evaluating Serum Insulin-Like Growth Factor 1 and Insulin-Like GrowthFactor Binding Protein 3 as Markers in Prostate Cancer Diagnosis

• Published in: The International journal of biological markers Vol. 31; no. 3; pp. 317 - 323
• Main Authors: Rainato Giulia, Fabricio Aline SC, Zancan Matelda, Peloso, Lucia, Dittadi Ruggero, Barichello, Mario, Fandella Andrea, Scattoni Vincenzo, Gion Massimo
• Format: Journal Article
• Language: English
• Published: Thousand Oaks Sage Publications Ltd 01.07.2016
• Subjects: Diagnosis; Hyperplasia; Insulin; Insulin-like growth factor I; Insulin-like growth factor-binding protein 3; Insulin-like growth factors; Isoforms; Medical diagnosis; Prostate cancer; Prostate-specific antigen; Serum levels; Statistical analysis
• ISSN: 0393-6155; 1724-6008
• DOI: 10.5301/jbm.5000200

Background Prostate-specific antigen (PSA) lacks specificity and sensitivity indiscriminating prostate cancer (PCa) from benign prostatic hyperplasia (BPH)when the total PSA (tPSA) level is between 4 and 10 ng/mL. It remains to beinvestigated if additional tumor-associated molecules may improve the PCadiagnostic accuracy. The aim of the present study was to investigate whetherserum levels of insulin-like growth factor 1 (IGF1), insulin-like growthfactor binding protein 3 (IGFBP3) and their combinations with PSA mayenhance the diagnosis of PCa. Methods Serum tPSA and free PSA (fPSA) levels were measured using an automatedchemiluminescence-based method. IGF1 and IGFBP3 levels were evaluated byradioimmunoassays in a prospectively and consecutively enrolled subset of149 patients with tPSA ≤10 ng/mL made up of patients with benign prostatichyperplasia (BPH; n = 113) and PCa (n = 36). Results IGF1 and IGFBP3 serum levels did not significantly differ between the PCa andBPH groups. No important correlation was found between the IGF molecules andPSA isoforms in both groups. Statistical analysis of the combination ofmarkers indicated that only the free/total PSA ratio (f/tPSA%) wasinformative and independent in predicting the presence of PCa, consideringthat for high values of this percentage (17%) the probability of finding PCadecreased. Receiver operating characteristics areas under the curve (AUC)for IGF1 and IGFBP3 were not informative (AUC ~0.5 in both cases) contraryto the AUC for f/tPSA% (AUC = 0.689, p = 0.0002). Conclusions The present study showed that neither IGF1 and IGFBP3 alone nor incombination with PSA enhance the diagnostic performance of PSA in PCa.