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Preoperative insulin-like growth factor-binding protein-3 (IGFBP-3) blood level predicts gleason sum upgrading

Authors

  • Daniela Terracciano,

    Corresponding author
    1. Department of Cellular and Molecular Biology and Pathology “L. Califano”, University of Naples “Federico II”, Naples, Italy
    • Dipartimento di Biologia e Patologia Cellulare e Molecolare “L.Califano” Università di Napoli “Federico II” Via Sergio Pansini, 5, 80131 Napoli, Italy.
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  • Dario Bruzzese,

    1. Department of Preventive Medical Sciences, University of Naples “Federico II”, Naples, Italy
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  • Matteo Ferro,

    1. Department of Urology, University of Naples “Federico II”, Naples, Italy
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  • Claudia Mazzarella,

    1. Department of Cellular and Molecular Biology and Pathology “L. Califano”, University of Naples “Federico II”, Naples, Italy
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  • Giuseppe Di Lorenzo,

    1. Department of Oncology, University of Naples “Federico II”, Naples, Italy
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  • Vincenzo Altieri,

    1. Department of Urology, University of Naples “Federico II”, Naples, Italy
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  • Angela Mariano,

    1. Department of Cellular and Molecular Biology and Pathology “L. Califano”, University of Naples “Federico II”, Naples, Italy
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  • Vincenzo Macchia,

    Corresponding author
    1. Department of Cellular and Molecular Biology and Pathology “L. Califano”, University of Naples “Federico II”, Naples, Italy
    • Dipartimento di Biologia e Patologia Cellulare e Molecolare “L.Califano” Università di Napoli “Federico II” Via Sergio Pansini, 5, 80131 Napoli, Italy.
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  • Angelina Di Carlo

    1. Department of Medical Surgical Sciences and Biotechnologies, University of Rome “La Sapienza”, Rome, Italy
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  • Daniela Terracciano and Dario Bruzzese are equally contributed to this work

Abstract

BACKGROUND

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).

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

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