Gut Liver.  2020 Nov;14(6):727-734. 10.5009/gnl19135.

Serum Insulin-Like Growth Factor Binding Protein 7 as a Potential Biomarker in the Diagnosis and Prognosis of Esophagogastric Junction Adenocarcinoma

Affiliations
  • 1Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, China
  • 2Precision Medicine Research Center , Shantou University Medical College, Shantou, China
  • 3Guangdong Esophageal Cancer Research Institute, Shantou University Medical College, Shantou, China
  • 4Radiation Oncology , the Cancer Hospital of Shantou University Medical College, Shantou, China
  • 5Oncological Laboratory Research, the Cancer Hospital of Shantou University Medical College, Shantou, China
  • 6Department of Dermatology and Venereology, Shantou Central Hospital, Shantou, China
  • 7Department of Biochemistry and Molecular Biology, Shantou University Medical College, Shantou, China

Abstract

Background/Aims
Esophagogastric junction adenocarci-noma (EJA) is a malignant tumor associated with high mor-bidity and has attracted increasing attention due to a rising incidence and low survival rate. Pathological biopsy is the gold standard for diagnosis, but noninvasive and effective tests are lacking, resulting in diagnoses at advanced stages. This study explored the diagnostic value of insulin-like growth factor binding protein 7 (IGFBP7) in EJA.
Methods
A total of 120 EJA patients and 88 normal controls were recruited, and their serum levels of IGFBP7 were measured by enzymelinked immunosorbent assay. Receiver operating character-istic (ROC) curve analysis was used to assess the diagnostic value, and Pearson chi-square analysis was used to evaluate the correlation between IGFBP7 and clinical parameters. Ka-plan-Meier survival analysis was carried out to assess the ef-fect of IGFBP7 on overall survival (OS).
Results
The levels of IGFBP7 were higher in both early- and late-stage EJA patients than in normal controls (p<0.001). The area under the ROC curve for EJA patients was 0.794 (95% confidence interval [CI], 0.733 to 0.854), with a cutoff value of 2.716 ng/mL, a sensitivity of 63.3% (95% CI, 54.0% to 71.8%) and a specific-ity of 90.9% (95% CI, 82.4% to 95.7%). For the diagnosis of early-stage EJA, the same cutoff value and specificity were obtained, but the sensitivity of IGFBP7 was 54.3% (95% CI, 36.9% to 70.8%). Patients with low IGFBP7 protein expres-sion had lower OS than those with high expression (p=0.034). The multivariate analysis showed that IGFBP7 is an inde-pendent prognostic factor for EJA (p=0.011).
Conclusions
Serum IGFBP7 acts as a potential diagnostic and prognostic marker for EJA.

Keyword

Insulin-like growth factor binding protein-7; Esophagogastric junction; Adenocarcinoma; Diagnosis; Prognosis
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