title: Preoperative insulin-like growth factor-binding protein-3 (IGFBP-3) blood level predicts gleason sum upgrading.
abstract: BACKGROUND
  About 43% of men with low Gleason grade prostate cancer (PCa) at biopsy will be finally diagnosed with high-grade PCa at radical prostatectomy (RP). Gleason sum at RP is a good indicator of biochemical recurrence and poor clinical outcome. Therefore, there is a need to improve clinical evaluation of PCa aggressiveness in order to choice appropriate treatment. To this aim an easy-available tool is represented by circulating biomarkers. Among these, the best candidates are some molecules involved in PCa pathogenesis such as IGFBP-2 and IGFBP-3, IL-6, and its soluble receptor (SIL-6R).
  
  
  METHODS
  In this study, we evaluated the ability of preoperative IGFBP-2, IGFBP-3, IL-6, and SIL-6R serum levels to predict Gleason score upgrade in 52 PCa patients.
  
  
  RESULTS
  We found that IGFBP-3 median levels were significantly lower in patients who showed Gleason upgrading from biopsy to RP (P = 0.024). We also found an association between biopsy T-stage and Gleason Upgrade (P = 0.011). Using multivariate logistic regression model, we demonstrated that the association of IGFBP-3 serum levels together with biopsy T-stage and biopsy Gleason score was useful to calculate a prognostic risk score. ROC curve analysis of risk score showed a good ability to predict GSU (AUC = 0.81; 95% CI 0.69-0.93).
  
  
  CONCLUSIONS
  Our results suggest that preoperative IGFBP-3 circulating levels determination may be useful to predict Gleason score upgrading alone and/or in combination with biopsy T-stage and biopsy Gleason score.
authors.affiliation: Department of Cellular and Molecular Biology and Pathology L. Califano, University of Naples Federico II, Naples, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Terracciano
authors.forename: Dario
authors.initials: D
authors.lastname: Bruzzese
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferro
authors.forename: Claudia
authors.initials: C
authors.lastname: Mazzarella
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Lorenzo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Altieri
authors.forename: Angela
authors.initials: A
authors.lastname: Mariano
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Macchia
authors.forename: Angelina
authors.initials: A
authors.lastname: Di Carlo
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology* / Q000601:surgery; D000368:Aged; D006801:Humans; D018971:Insulin-Like Growth Factor Binding Protein 2 / Q000097:blood; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D019947:Receptors, Interleukin-6 / Q000097:blood
chemical_list: D018971:Insulin-Like Growth Factor Binding Protein 2; D018972:Insulin-Like Growth Factor Binding Protein 3; D015850:Interleukin-6; D019947:Receptors, Interleukin-6; C113250:interleukin-6 receptor alpha; D017430:Prostate-Specific Antigen