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Preoperative insulin‐like growth factor‐binding protein‐3 (IGFBP‐3) blood level predicts gleason sum upgrading
Author(s) -
Terracciano Daniela,
Bruzzese Dario,
Ferro Matteo,
Mazzarella Claudia,
Di Lorenzo Giuseppe,
Altieri Vincenzo,
Mariano Angela,
Macchia Vincenzo,
Di Carlo Angelina
Publication year - 2012
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.21411
Subject(s) - medicine , prostate cancer , biopsy , prostatectomy , stage (stratigraphy) , urology , logistic regression , prostate biopsy , prostate , prostate specific antigen , oncology , cancer , paleontology , biology
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.