Levels Of IGF1, IGFBP3 And VEGF In Non-small Cell Lung Cancer And Their Correlation Analysis With Clinicopathological Features

Objective: To investigate the levels of IGF1,IGFBP3 and VEGF in non-small cell lung cancer and their correlation with clinicopathological features.To investigate the relevant tumor neovascular biomarkers and anti-angiogenesis therapy.Methods:A retrospective analysis of clinical data of 50 NSCLC patients who haven’t been treated and were diagnosed with lung cancer by cytology and pathology in First Affiliated Hospital of Soochow University from July 2016 to March 2017.The levels of IGF1,IGFBP3 and VEGF in those patients’ blood serum were detected respectively.Among them,13 patients underwent chemotherapy containing bevacizumab or recombinant human endostatin injection.The levels of VEGF were detected during chemotherapy in 13 patients.The efficacy of patients was evaluated after receiving 4-6 cycles of chemotherapy containing bevacizumab or recombinant human endostatin injection.Results: 50 cases of elderly NSCLC patients included 35 male cases and 15 female cases and ranged in age from 47-83 years old,an average of 67.4 ±8.4 years old;The pathologic types of NSCLC were mainly adenocarcinoma(54%,27/50),with poorly differentiated(30%,15/27);secondly squamous carcinoma(40%,20/50),with poorly differentiated(60%,12/20);restly adenosquamous carcinoma(6%,3/50);50 cases of NSCLC were found distant metastasis accounted for 20%(10/50),with bone metastasis(10%,5/50),brainmetastases(2%,1/50)and liver metastasis(8%,4/50);NSCLC with malignant pleural effusion accounted for 26%(13/50);the levels of IGF1,IGFBP3 and VEGF dected were respectively(139.22±34.83)ng/ml,(3.15±0.72)ng/ml and(173.07±62.08)ng/mlin in non-small cell lung cancer;Correlation analysis showed that,the levels of IGF-1 had significant negative correlation with the levels of IGFBP3(r =-0.725,P<0.05),the levels of IGF-1 had significant positive correlation with the levels of VEGF(r=0.834,P<0.05);The levels of IGFBP-1,IGFBP-3 and VEGF had no significant difference in different genders,ages and pathologic types(P >0.05);however high plasma levels of IGF1 and VEGF were associated with later stage,low differentiation,distant metastasis and malignant pleural effusion in non-small cell lung cancer(P<0.05),conversely,low plasma levels of IGFBP3 were associated with that.We found that baseline circulating levels of VEGF were not associated with the response to the antiangiogenic treatment(P > 0.05),whereas >30% reduction in VEGF levels detected during chemotherapy from baseline was associated with the response to the antiangiogenic treatment(P<0.05).Conclusion:1.The levels of IGF1,IGFBP3 and VEGF in serum of patients newly diagnosed with NSCLC were correlated with tumor stage,degree of differentiation,distant metastasis and malignant pleural effusion,but not with gender,age and pathological type.2.Anti-angiogenesis drugs treated patients with >30% reduction in VEGF levels detected during chemotherapy from baseline showed better response than the others,which suggests that a sustained high level of VEGF may be a biomarker of poor prognosis in NSCLC patients.3.IGF1,IGFBP3,VEGF and other angiogenesis-related factors are related to each other and involved in the occurrence,progression and metastasis of NSCLC,suggesting that anti-angiogenesis therapy should focus on the entire tumor microenvironment(immune,inflammation related factors,etc.),and multitargeted antiangiogenesis inhibitors should be combined in NSCLC personalized therapy.