IGF-1 ve IGFBP3’ün Özofagus Kanseri’nin Tanı ve Tedaviye Yanıtındaki Yerinin Araştırılması

Year 2019, , 852 - 863, 31.12.2019

Süleyman Bademler Merve Müge Üçüncü Murat Serilmez

https://doi.org/10.38079/igusabder.586721

Abstract

Amaç: Özofagus kanseri dünya genelinde tüm kanserler arasında sekizinci sırada yer almaktadır. Tüm kanserlerin % 1,5–2'sini, sindirim sistemi kanserlerinin ise % 5-7'sini oluşturmaktadır. Bu kanser türünde erken tanı, erken tedavi ve yakın takiple mortalite azaltılabilmektedir.  Ancak erken tanı konabilmesi için erken tanıda kullanılabilecek hızlı sonuç alınan, güvenilir belirteçlere ihtiyaç vardır. Çalışmamızda özofagus tümörünün erken tanısı için IGFBP3 ve IGF-1’in kullanılabilirliğini araştırmayı amaçladık. 

Yöntem: Çalışmaya patolojik olarak özofagus kanseri tanısı alan ve İstanbul Üniversitesi Onkoloji Enstitüsünde takip edilen 37 özofagus kanserli hasta ve 41 kanser tanısı olmayanlar dahil edilmiştir. Serum IGF-1 ve IGFBP3 seviyeleri ELISA yöntemi ile belirlenmiştir. 

Bulgular: Çalışmaya alınan hastaların yaş ortalaması 54.51±13.69 yıldır. Gruplar arasında yapılan değerlendirmede cinsiyet ve yaş arasında fark yoktur (p=0,675 ve 0,094). Çalışmaya alınan hastalardan kontrol grubu ile vaka grubu arasında IGF-1 ve IGFBP3 arasında istatistiki anlamlı fark vardır. Kontrol grubunda her iki değerde daha yüksektir (p=0,006, p<0,001). 22 hastada nüks gözlenmiştir. Nüks gelişmesinde IGF ve IGFBP3 seviyeleri arasında anlamlı fark gözlenmemiştir. 32 hasta ex olmuştur. Hastalığın histolojik alt tip, T ve patolojik evreleri arasında IGF-1 ve IGFBP3 arasında anlamlı fark bulunmamıştır. 

Sonuç: Çalışmamızda özofagus tümör tanısı için IGF-1 ve IGFBP3 markerlarının kullanılabileceğini göstermektedir. Net kanıya varmak için daha geniş örnek gruplarında çalışılması gerekliliği kanaatine varılmıştır.

Keywords

Özofagus kanseri, IGF-1 seviyesi, IGFBP-3 seviyesi, erken tanı, tümör marker, sindirim sistemi kanseri

An Investigation into the Role of IGF-1 and IGFBP3 in the Diagnosis and Treatment Response in Esophageal Cancer

Abstract

Aim: Esophageal cancer (EC) is the eighth most common cancer among all cancers worldwide. It constitutes 1.5-2% of all cancers and 5-7% of gastrointestinal cancers. Mortality reduction by early diagnosis, early treatment, and close follow-up is possible in esophageal cancer. However, reliable markers that rapidly provide results for early diagnosis are necessary in order to make such a diagnosis. In our study, it is aimed to investigate the role of IGFBP3 and IGF-1 in the early diagnosis of esophageal tumors. 

Method: 37 patients with a histopathologically confirmed diagnosis of EC and 41 age- and sex-matched healthy controls were included in our study at Istanbul University Institute of Oncology. Serum IGF-1 and IGFBP-3 levels were determined using enzyme-linked immunosorbent assay (ELISA).

Findings: The mean age of the patients included in this study was 54.51±13.69 years. Based on the comparison between the groups, there was no difference in terms of gender and age (p=0.675 and 0.094). There was a statistically significant difference between the control group and the patient group in terms of IGF-1 and IGFBP3 levels. Both levels were higher in the control group (p=0.006, p<0.001). 22 patients had a recurrence. There was no significant difference between the IGF and IGFBP3 levels in those who had a recurrence. 32 patients died. There was no significant difference in terms of the histological subtype, T and pathologic stage of the disease, and IGF-1 and IGFBP3 levels. 

Conclusion: Our study showed that IGF-1 and IGFBP3 markers could be used in the diagnosis of esophageal tumors. We think that it is necessary to conduct further studies with larger series in order to draw a clear conclusion.

Keywords

Esophageal cancer, İGF 1 levels, İGFBP3 levels, serum, early diagnosis, tumor marker, gastrointestinal system cancer

References

• Pennathur A, Gibson MK, Jobe BA, Luketich JD. Oesophageal carcinoma. Lancet. 2013;381:400-412. doi: 10.1016/S0140-6736(12)60643-6
• National Cancer Insti¬tute. SEER Cancer Statistics Review, 1975-2013. Based on November 2015 SEER data submission, posted to the SEER website, April 2016. https://seer.cancer.gov/archive/csr/1975_2013/ Accessed September 21, 2018
• Short MW, Burgers KG, Fry VT. Esophageal cancer. American Family Physician. 2017;95(1):22-28. PMID: 28075104
• Rahman OA. Insulin-like growth factor pathway aberrations and gastriccancer; evaluation of prognostic significance and assessmentof therapeutic potentials. Medical Oncology. 2015;32(1):431. doi: 10.1007/s12032-014-0431-8
• Furstenberger G, Senn HJ. Insulin-like growth factors and cancer. The Lancet Oncology. 2002;3(5):298-302
• Pollak MN, Schernhammer ES, Hankinson SE. Insulin-like growth factors and neoplasia. Nature Reviews Cancer. 2004;4(7):505–518. doi: 10.1038/nrc1387
• Bademler S, Sarı M, Üçüncü MZ, Serilmez M, Karabulut S. Clinical significance of serum insulin-like growth factor-1 (IGF-1) and insulinlike growth binding protein-3 (IGFBP-3) in patients with gastric cancer. Acta Medica Mediterranea. 2018;34:2055-2061 doi: 10.19193/0393-6384_2018_6_320
• Bademler S, Zırtıloğlu A, Sarı M, Yasasever CT, Karabulut S. IGF-1 AND IGFBP-3 in colorectal cancer, an observational case-control study. Acta Medica Mediterranea. 2019;35:15-21. doi: 10.19193/0393-6384_2019_1_1
• Li H, Batth IS, Qu X, et al. IGF-IR signaling in epithelial to mesenchymal transition and targeting IGFIR therapy: overview and new insights. Molecular Cancer. 2017;16(1):6 doi: 10.1186/s12943-016-0576-5
• Miller BS, Yee D. Type I insulin-like growth factor receptor as a therapeutic target in cancer. Cancer Research. 2005;65(22):10123–7. doi: 10.1158/0008-5472.CAN-05-2752
• Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics. CA Cancer Journal for Clinicians. 2012;65(2):87-108. doi: 10.3322/caac.21262
• Varghese TK Jr, Hofstetter WL, Rizk NP, et al. The Society of Thoracic Surgeons guidelines on the diagnosis and staging of patients with esophageal cancer. Annals of Thoracic Surgery. 2013;96(1):346-56. doi: 10.1016/j.athoracsur.2013.02.069
• Ajani JA, D'Amico TA, Almhanna K, et al. National comprehensive cancer network. Esophageal and esophagogastric junction cancers, version 1.2015. Journal of The National Comprhensive Cancer Network. 2015;13(2):194-227. doi:10.6004/jnccn.2015.0028
• Rustgi AK, El-Serag HB. Esophageal carcinoma. The New England Journal of Medicine. 2014;371:2499-2509. doi: 10.1056/NEJMra1314530
• Rice TW, Blackstone EH, Rusch VW. 7th edition of the AJCC Cancer Staging Manual: esophagus and esophagogastric junction. Annals of Surgical Oncology. 2010;17(7):1721-4. doi: 10.1245/s10434-010-1024-1.
• Fitzgerald RC, di Pietro M, Ragunath K, et al. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett’s oesophagus. Gut. 2014;63(1):7-42. doi: 10.1136/gutjnl-2013-305372.
• Smithers BM, Gotley DC, Martin I, Thomas JM. Comparison of the outcomes between open and minimally invasive esophagectomy. Annals of Surgery. 2007;245(2):232–240. doi: 10.1097/01.sla.0000225093.58071.c6
• Baxter RC. Signalling pathways involved in antiproliferative effects of IGFBP-3: a review. Molecular Pathology. 2001;54(3):145–148. doi: 10.1136/mp.54.3.145
• Adachi Y, Nojima M, Mori M, et al. Insulin-like growth factor-1, IGF binding protein-3, and the risk of esophageal cancer in a nested case-control study. World Journal of Gastroenteroly. 2017;23(19):3488-3495. doi: 10.3748/wjg.v23.i19.3488
• Li J, Wang A, Song L, Zhao J. Expressıon and clinical significance Of AEG-1, E-Ca And IGFBP-3 in esophageal cancer patients. Acta Medica Mediterranea, 2018;34:1671. doi: 10.19193/0393-6384_2018_6_256