结直肠腺瘤患者血清IGF-1和IGFBP-3的变化及其临床意义

Clinical significance of serum levels of IGF-1 and IGFBP-3 in patients with colorectal adenoma

目的:研究血清胰岛素样生长因子1(insulin-like growth factor1,IGF-1)和胰岛素样生长因子结合蛋白3(insulin-like growth factor binding protein3,IGFBP-3)在结直肠腺瘤患者中的变化及临床意义.方法:采用放射免疫法和免疫放射法分别检测120例结直肠腺瘤患者、48例结直肠癌患者及34例健康人外周血清IGF-1和IGFBP-3表达水平.结果:血清IGF-1和IGF-1/IGFBP-3比值在结直肠癌组(247.35±60.77;0.063±0.010)、腺瘤性息肉组(224.75±69.45;0.055±0.010)及健康对照组(195.39±63.37;0.047±0.013)依次降低,前两组明显高于后组,差异有统计学意义(P<0.05).腺瘤性息肉患者血清IGF-1、IGFBP-3水平及IGF-1/IGFBP-3比值与患者的性别、年龄、吸烟饮酒情况及肿瘤家族史临床指标间均无统计学意义;与息肉大小、数量、部位、组织学分类也无统计学意义.血清IGF-1和IGF1/IGFBP-3比值在结直肠癌组(247.35±60.77;0.063±0.010)、进展期腺瘤组(235.81±73.72;0.056±0.011)及早期腺瘤组(208.15±59.44;0.052±0.008)依次降低,且前两组较后组比,差异有显著性(P<0.05).结直肠腺瘤性息肉患者血清IGF-1和IGFBP-3呈正相关(r=0.796,P<0.001).结论:血清IGF-1和IGF-1/IGFBP-3比值增高可能在结直肠腺瘤癌变中起一定作用,对适龄人群行血清GF-1和IGF-1/IGFBP-3检测可以简单筛选有息肉恶变倾向者.

AIM：To investigate the clinical significance of serum levels of IGF-1 and IGFBP-3 in patients with colorectal adenoma. METHODS：Blood samples collected from 120 patients with colorectal adenoma （CRA）, 48 patients with colorectal cancer （CRC） and 34 healthy controls were used to determine serum levels of IGF-l and IGFBP-3 by radioimmunoassay （RIA） and immunoradiometric assay （IRMA）, respectively.RESULTS：Serum levels of IGF-1 and IGF-1/ IGFBP-3 ratio in the CRC group （247.35 ± 60.77; 0.063 ± 0.010） and CRA group （224.75 ± 69.45; 0.055 ± 0.010） were significantly higher than those in the healthy control group （195.39 ± 63.37; 0.047 ± 0.013） （both P 〈0.05）. Serum IGF-1, IGFBP-3, and IGF-1/IGFBP-3 ratio in CRA showed no significant association with gender, age, history of smoking and drinking, family history of cancer, and the size, number, site or histological classification of polyps. Serum levels of IGF-1 and IGF-1/IGFBP-3 ratio in the CRC group （247.35 ± 60.77; 0.063 ± 0.010） and highrisk CRA group （235.81 ± 73.72; 0.056 ± 0.011） were significantly higher than those in the advanced CRA group （208.15 ± 59.44; 0.052 ± 0.008） （all P 〈0.05）. There was a positive correlation between serum levels of IGF-1 and IGFBP-3 in CRA （r = 0.796, P 〈0.001）. CONCLUSION：High serum levels of IGF-1 and IGF-1/ IGFBP-3 may play a role in the malignant transformation of colorectal adenoma, and detection of them can be used to screen precancerous lesions.