Correlation of preoperative levels of IGF-I and IGFBP-3 with pathologic parameters and clinical outcome in patients with bladder cancer.
OBJECTIVE
To test the hypothesis that plasma insulin growth factor (IGF)-I or IGF binding protein (BP)-3 levels would differ between patients with bladder cancer and healthy controls and whether preoperative plasma IGF-I or IGFBP-3 could predict the pathologic characteristics and clinical outcome of patients with bladder cancer undergoing radical cystectomy. The IGFs are mitogens that have been shown to play a significant role in regulating proliferation and differentiation of bladder cancer cells.


METHODS
The study group consisted of 51 patients who underwent radical cystectomy (median follow-up 45.7 months). The preoperative plasma levels of IGF-I and IGFBP-3 were measured using DSL-enzyme-linked immunosorbent assays. The IGF-I and IGFBP-3 levels were also measured in 44 healthy men.


RESULTS
The plasma IGF-I and IGFBP-3 levels in patients with bladder cancer were not significantly different from those in healthy subjects (P >or=0.339). In a preoperative model that included clinical grade, clinical stage, and either IGF-I or IGFBP-3, none of the parameters was associated with either metastases to lymph nodes or clinical outcome. However, in an alternative model that included both IGF-I and IGFBP-3 in addition to clinical stage and grade, only a lower preoperative plasma IGFBP-3 level was associated with metastases to regional lymph nodes, bladder cancer progression, and survival (P = 0.047, 0.050, and 0.040, respectively).


CONCLUSIONS
We found no association between preoperative plasma IGF-I and bladder cancer characteristics or outcome, limiting the clinical utility of IGF-I. In contrast, a lower preoperative plasma level of IGFBP-3 was associated with lymph node metastasis and poorer clinical outcome after radical cystectomy when adjusted for IGF-I level.
Shariat
Shahrokh F
SF
Baylor Prostate Center, Scott Department of Urology, Baylor College of Medicine, and Methodist Hospital, Houston, Texas 77030-2706, USA.
Kim
JaHong
J
Nguyen
Cuong
C
Wheeler
Thomas M
TM
Lerner
Seth P
SP
Slawin
Kevin M
KM
D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D015653:Cystectomy / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery*
D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I