膀胱癌患者血清IGF-I、IGFBP-3 水平及其临床意义

Serum levels of IGF-Ⅰ and IGFBP-3 in patients with bladder cancer and their clinical significance

摘要:

目的 探讨膀胱癌患者血清胰岛素样生长因子- Ⅰ（IGF- Ⅰ）、胰岛素样生长因子结合蛋白-3 （IGFBP-3）水平，及其与膀胱癌病理特征的关系。方法 选取在该院泌尿外科行手术治疗的膀胱癌患者200 例 作为膀胱癌组，同期健康体检者200 例作为对照组，测定血清IGF- Ⅰ、IGFBP-3 水平。结果 膀胱癌组患 者血清IGF- Ⅰ、IGFBP-3 水平低于对照组（P <0.05），IGF- Ⅰ /IGFBP-3 比值高于对照组（P <0.05）。膀 胱癌患者术后血清IGF- Ⅰ、IGFBP-3 水平高于术前（P <0.05），IGF- Ⅰ /IGFBP-3 比值低于术前（P <0.05）。 低级别膀胱癌患者血清IGF- Ⅰ、IGFBP-3 水平高于高级别（P <0.05）；高、低级别胱癌患者IGF- Ⅰ / IGFBP-3 比值比较，差异无统计学意义（P >0.05）。肌层浸润性膀胱癌患者血清IGF- Ⅰ、IGFBP-3 水平低 于非肌层浸润性（P <0.05）；肌层浸润性与非肌层浸润性膀胱癌患者IGF- Ⅰ /IGFBP-3 比值比较，差异无 统计学意义（P >0.05）。T3、T4 期患者血清IGF- Ⅰ、IGFBP-3 水平低于Ta ～ T2 期（P <0.05）；淋巴结转 移患者血清IGF- Ⅰ、IGFBP-3 水平低于无淋巴结转移患者（P <0.05）。结论 膀胱癌患者血清IGF- Ⅰ、 IGFBP-3 水平下降，血清IGF- Ⅰ、IGFBP-3 水平有望成为膀胱癌诊断和预后评价的检测指标。

Abstract:

Objective To investigate the levels of serum insulin-like growth factor Ⅰ (IGF-Ⅰ) and insulin-like growth factor binding protein 3 (IGFBP-3) in bladder cancer patients and their relationships with the pathological features of bladder cancer. Methods Two hundreds patients with bladder cancer treated in Department of Urology of our hospital from January 2015 to December 2017 were taken as the bladder cancer group and 200 healthy patients during the same period were treated as the control group. The serum IGF-Ⅰ and IGFBP-3 levels were measured. Results The serum IGF-Ⅰ and IGFBP-3 levels in the bladder cancer group were lower than those in the control group (P < 0.05), and IGF-Ⅰ/IGFBP-3 in the bladder cancer group was higher than that in the control group (P < 0.05). In the patients with bladder cancer, the serum IGF-Ⅰ and IGFBP-3 levels after surgery were significantly higher than those before surgery (P < 0.05), and IGF-Ⅰ/IGFBP-3 was lower than that before surgery (P < 0.05). The serum IGF-Ⅰ and IGFBP-3 levels in the patients with low-grade bladder cancer were higher than those in the highgrade bladder cancer patients (P < 0.05), and IGF-Ⅰ/IGFBP-3 in the patients with low-grade bladder cancer was not significantly different from that in the high-grade bladder cancer patients (P > 0.05). The serum levels of IGF-Ⅰ and IGFBP-3 in the bladder cancer patients with intramuscular invasion were lower than those in the patients without muscular infiltration (P < 0.05), while there was no significant difference in IGF-Ⅰ/IGFBP-3 between the bladder cancer patients with muscular invasion and those without muscle infiltration (P > 0.05). The serum levels of IGF-Ⅰ and IGFBP-3 of the patients in stage T3 or T4 were lower than those of the patients in stage Ta-T2 (P < 0.05). The serum levels of IGF-Ⅰ and IGFBP-3 in the patients with lymph node metastasis were lower than those without lymph node metastasis (P < 0.05). Conclusions Serum IGF-Ⅰ and IGFBP-3 levels decrease in the patients with bladder cancer. Serum IGF-Ⅰ and IGFBP-3 levels are expected to be indicators for the diagnosis and prognosis evaluation of bladder cancer.