Preoperative Level of Insulin-Like Growth Factor Binding Protein 2 Predicts The Suboptimal Outcome After Primary Debulking Surgery in Patients with Advance Ovarian Cancer

The Indonesian Biomedical Journal Pub Date : 2023-12-11 DOI:10.18585/inabj.v15i6.2722

Pande Kadek, Aditya Prayudi, Gde Sastra, I. Nyoman, Gede Budiana, Kade Yudi, I. Saspriyana, Nyoman Bayu, Ketut Mahendra, Suwiyoga

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Abstract

BACKGROUND: The need for clinically useful biomarkers which can predict the surgical outcome after primary debulking surgery (PDS) in patients with advance ovarian cancer (AOC) is really important. Insulin-like growth factor-binding protein 2 (IGFBP2) is the main binding protein expressed by ovarian cancer cells, which plays a prominent role in promoting proliferation, driving invasion, and suppressing apoptosis. This study was conducted to assess the performance of IGFBP2 in predicting the surgical outcome after PDS in patients with AOC.METHODS: Twenty-four subjects with AOC (Stage IIIc/IV) who underwent PDS were recruited consecutively. Clinicopathologic data were obtained from subjects' medical records. Blood samples were withdrawn form each subject and preoperative level of IGFBP2 were measured using enzyme-linked immunosorbent assay (ELISA). Multivariate analysis was employed to test the performance of multiple predictors of surgical outcome.RESULTS: Eighteen patients (75%) had suboptimal outcome after PDS. Mean IGFBP2 level was significantly higher in the suboptimal group (1157.5±359.9 ng/mL vs. 679.1±504.5 ng/mL, p=0.018). In bivariate model, higher preoperative level of IGFBP2 predict the suboptimal outcome with good accuracy (AUC: 0.796, sensitivity: 83.3%, specificity: 83.3%, p=0.033, optimal threshold level 870 ng/mL). Higher IGFBP2 level was associated with higher risk of suboptimal outcome, although IGFBP2 was not an independent risk factor (adjusted OR: 5.0, 95% CI: 0.43-57.9, p=0.198).CONCLUSION: IGFBP2 is a novel and promising biomarker for surgical outcome prediction following PDS in AOC patients. Since it is predictive for suboptimal outcome, patients with higher preoperative level of IGFBP2 needs more thorough preoperative evaluation as well as meticulous surgical technique to optimize the surgical outcome.KEYWORDS: IGFBP2, advance ovarian cancer, PDS, surgical outcome, predictor

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胰岛素样生长因子结合蛋白 2 的术前水平可预测晚期卵巢癌患者原发性切除手术后的不良预后

背景：临床上非常需要能预测晚期卵巢癌（AOC）患者初次剥离手术（PDS）后手术结果的生物标志物。胰岛素样生长因子结合蛋白 2（IGFBP2）是卵巢癌细胞表达的主要结合蛋白，在促进增殖、驱动侵袭和抑制凋亡方面发挥着突出作用。本研究旨在评估 IGFBP2 在预测 AOC 患者 PDS 后手术结果方面的表现。临床病理学数据来自受试者的医疗记录。抽取每位受试者的血液样本，并使用酶联免疫吸附试验（ELISA）测量术前 IGFBP2 的水平。结果：18 名患者（75%）在 PDS 术后的结果不理想。次优组的平均 IGFBP2 水平明显更高（1157.5±359.9 ng/mL vs. 679.1±504.5 ng/mL，P=0.018）。在双变量模型中，术前 IGFBP2 水平越高，预测次优结果的准确性越高（AUC：0.796，灵敏度：83.3%，特异性：83.3%，p=0.033，最佳阈值水平为 870 ng/mL）。结论：IGFBP2 是预测 AOC 患者 PDS 后手术预后的一种新颖且有前景的生物标志物。结论：IGFBP2 是预测 AOC 患者 PDS 手术预后的一个新颖而有前景的生物标志物。由于它可预测不理想的预后，因此术前 IGFBP2 水平较高的患者需要更全面的术前评估和细致的手术技巧，以优化手术预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The Indonesian Biomedical Journal

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