| Objective:To investigate the serum levels of IGF-1,IGFBP-2,and CEA expression in non-small cell lung cancer(NSCLC),benign lung disease,and healthy volunteers.The sensitivity and specificity of the three methods for the diagnosis of NSCLC were compared.To clarify serum IGF-1,IGFBP-2 levels connection between the tumor progression situations in patients with NSCLC.Methods:According to the 8th edition of lung cancer TNM staging standard developed by the International Association for the Study of Lung Cancer(IASLC)in 2015 and WHO lung histological classification criteria.From June 2017 to December 2017,50non-small cell lung cancer patients admitted to the the Department of Respiratory Medicine of the Second Affiliated Hospital of Nanchang University.There were 25 patients with benign lung disease hospitalized during the same period were treated.13 healthy people as the healthy controls group.Collect the sera of all preliminary enrolled subjects before receiving treatment,and the concentrations of IGF-1 and IGFBP-2 in the three groups were measured by ELISA.The concentrations of serum CEA were measured by chemiluminescence immunoassay,and the data were then statistically analyzed using SPSS 21.0 software.Result:1、The serum levels of IGF-1 in the NSCLC group was(129.9±29.4 ng/ml),which was significantly higher than that of the benign lung disease group [(91.7±30.0)ng/ml] and the healthy controls group [(91.5±18.3)ng/ml];The serum levels ofIGFBP-2 in the NSCLC group was(14068.9±2114.5 ng/ml),which was significantlyhigher than that in benign lung disease group [(12078.3±2268.6)pg/ml] and healthycontrols group[(11690.6±2282.2)pg/ml],the difference was statistically significant(P <0.001).2、There was no significant correlation between serum IGF-1,IGFBP-2levels and age,sex,smoking status and pathological types(P<0.05),The serumlevels of IGF-1 and IGFBP-2 were significantly correlated with clinical stage,lymph node metastasis and distant metastasis of lung cancer(such as violation of pleura,bone,brain,liver,etc.)(P<0.05).Specifically,Serum IGF-1 in patients with TNM III-IV stage was(134.4±33.8 ng/ml),which was significantly higher than patientswith TNM I-II stage(116.3±20.2 ng/ml)(P<0.05).Serum IGF-1 levels in patients with lymph node metastasis were significantly higher than those without lymph node metastasis(135.4±33.6 ng/ml vs 115.0±20.2 ng/ml,P<0.05);The patients with distant metastasis was significantly higher than patients without distant metastasis(140.2±35.5 ng/ml vs 121.8±22.6 ng/ml,P<0.05).Serum IGFBP-2 was(14449.4±1896.3 pg/ml)in TNM III-IV stage NSCLC patients,which wassignificantly higher than TNM I-II stage patients(12985.7±2398.5 pg/ml)(P<0.05).Serum IGFBP-2 levels in patients with lymph node metastasis were significantly higher than those without lymph node metastasis(14508.4±1898.3 pg/ml vs12939.4±2289.1 pg/ml,P<0.05).The patients with distant metastasis was significantly higher than patients without distant metastasis(14764.7±2005.0 pg/ml vs.13476.0±2057.7 ng/ml,P<0.05).3、There is a positive correlation between IGF-1 and IGFBP-2 in serum of NSCLC patients(r=0.389,P=0.007),there is no significant correlation between IGF-1 and CEA(r=0.184,P=0.103),there is no significant correlation between IGFBP-2 and CEA(r=0.136,P=0.205).4、The receiver operating characteristic(ROC)curve analysis showed that the cutoff values for serum IGF-1,IGFBP-2,and CEA levels in the diagnosis of NSCLC were 106.5 ng/ml,13822.1 pg/ml,3.68 ng/ml.The area(AUC)were 0.825,0.755,0.804.The sensitivity of the three areas was 78.0%,62.0%,76.0%,and the specificity was 78.9%,81.6%,76.3%.The positive predictive values were 83.0%,78.9%,94.1%,and the negative predictive values were 73.1%,60.0%,52.1%.The sensitivity and specificity of the two or three combined tests were significantly better than those of the single test.Among them,the combined detection of IGF-1,IGFBP-2 and CEA was the highest sensitivity(90.0%),and the combined detection of IGFBP-2 and CEA was the highest specificity(86.8%).Conclusions:1、The serum levels of IGF-1,IGFBP-2 may be closely related to the occurrence and development of lung cancer.2、The expression of IGF-1 and IGFBP-2 in serum of NSCLC patients is closely related to the clinical stage,lymph node metastasis and distant metastasis(such as violation of pleura,bone,brain,liver,etc.),This suggest that IGF-1,IGFBP-2 may be closely related to malignant biological behavior such as local invasion and distant metastasis of lung cancer.3、The serum levels of IGF-1 and IGFBP-2 can be used as a potential biomarker for the clinical diagnosis of lung cancer patients.Combined detection with multiple indicators such as CEA can complement each other and further increase the diagnostic positive rate,but large sample data are needed to further confirm the clinical trials. |
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