Daniela Terracciano and Dario Bruzzese are equally contributed to this work
Preoperative insulin-like growth factor-binding protein-3 (IGFBP-3) blood level predicts gleason sum upgrading†
Article first published online: 25 APR 2011
Copyright © 2011 Wiley Periodicals, Inc.
Volume 72, Issue 1, pages 100–107, January 2012
How to Cite
Terracciano, D., Bruzzese, D., Ferro, M., Mazzarella, C., Di Lorenzo, G., Altieri, V., Mariano, A., Macchia, V. and Di Carlo, A. (2012), Preoperative insulin-like growth factor-binding protein-3 (IGFBP-3) blood level predicts gleason sum upgrading. Prostate, 72: 100–107. doi: 10.1002/pros.21411
- Issue published online: 24 NOV 2011
- Article first published online: 25 APR 2011
- Manuscript Received: 20 OCT 2011
- Manuscript Accepted: 5 APR 2011
- Gleason upgrading
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).
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.
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).
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. Prostate 72:100–107, 2012. © 2011 Wiley Periodicals, Inc.