Pilot Study of Elevated Levels of Insulin-Like Growth Factor-Binding Protein-2 as Indicators of Hepatocellular Carcinoma

Abstract

Background/Aims: Insulin-like growth factor-binding protein-2 (IGFBP-2) is expressed in many malignant tissues, and elevated serum levels can be indicators of tumour activity in addition to conventional tumour markers. Our aim was to evaluate the role of IGFBP-2 levels together with insulin-like growth factor (IGF)-I, IGF-II and IGFBP-3 in the diagnostic work-up of patients with hepatocellular carcinoma (HCC). Methods: In 50 (39 males, 11 females) histologically confirmed and TNM-graded patients with HCC who had not received adjuvant chemotherapy, the basal serum levels of IGF-I, IGF-II, IGFBP-3, IGFBP-2 and α-fetoprotein (AFP) were measured. The median age of the patients was 66 (37–84) years, body mass index was normal (25 (35–16) kg/m²). Results: The levels of IGF-I, IGF-II and IGFBP-3 were diminished, as is the case when nutrition, hepatic function and growth hormone (GH) secretion are decreased. The levels of AFP and IGFBP-2 were markedly high. In 37 cases, IGFBP-2 levels were above the age-related norm, and in 40 cases AFP levels were also elevated. In 3 cases, both AFP and IGFBP-3 were normal, and in 4 cases AFP was high but IGFBP-2 normal, whereas in 10 cases AFP was normal but IGFBP-2 was high. Conclusions: In addition to AFP, IGFBP-2 appears to be a suitable marker for the evaluation of the serological status of HCC patients. A longitudinal study during disease management is required to assess the full potential of IGFBP-2 measurements as a marker.

The Circulating IGF System in Hepatocellular Carcinoma: The Impact of Liver Status and Treatment

“…By contrast, serum IGFBP-2 was significantly elevated in HCC patients regardless of cirrhosis status, being 5-fold higher than in healthy controls ( Table 2). Our observation is in excellent agreement with earlier findings by Ranke et al, who in 50 HCC patients observed an increase in IGFBP-2 of similar magnitude, irrespective of the presence or absence of cirrhosis [36]. In conjunction, the two studies suggest that IGFBP-2 may serve as a marker of HCC, but only among patients without liver cirrhosis, as patients with cirrhosis but without HCC had even higher IGFBP-2 levels.…”

Diagnostic utility of leptin and insulin-like growth factor binding protein-2 in hepatocellular carcinoma of diabetic and non-diabetic Egyptian patients

“…In our study, serum levels of IGFBP-2 showed significant increase in both diabetic and non-diabetic HCC patients. These data are in accordance with previous reports indicating that serum levels of IGFBP-2 were significantly higher while IGFBP-3 levels were normal [36] or significantly lower [37] in patients with HCC compared to healthy subjects.…”

Gene expression profiling in glioblastoma and immunohistochemical evaluation of IGFBP-2 and CDC20

“…It acts not only as carrier of IGFs, prolonging their half-life, but also functions as modulator of IGF availability and activity. IGFBP-2 is over-expressed in ovarian [15], colorectal [16], prostate [17,18], hepatocellular carcinomas [19] and in neuroblastoma [20]. It has also been demonstrated that IGFBP-2 over-expression might promote glioma development and progression [21] and enhance GB invasion [22].…”