Serological levels of IGF-1 and IGFBP-3 in patients with Barrett's esophagus and esophageal adenocarcinoma: Longitudinal study

Abstract

Barrett's oesophagus (BE) is an entity with a known histological progression to malignancy. The Insulin-Like Growth Factor (IGF) system is involved in the carcinogenesis through obesity-related mechanisms that include IGF and it has been associated with several types of cancer. To evaluate the serological levels of IGF-1 and IGFBP-3 in patients with BE and esophageal adenocarcinoma. Prospective study of patients with BE and esophageal adenocarcinoma who underwent upper endoscopy between September 2012 and December 2015. A baseline determination of IGF-1 and IGFBP-3 was performed. We included a control group of patients without BE. 116 patients were included: 36 controls, 62 with BE (42 without dysplasia and 20 with dysplasia) and 18 with adenocarcinoma. IGF-1 and IGF-1/IGFBP-3 mol ratio showed a progression to high levels in BE and adenocarcinoma than in controls (IGF-1: 135.55 ± 66.07 ng/mL, 148.33 ± 81.5 ng/mL, 108.19 ± 46.69 ng/mL, respectively; p = 0.049) (molar ratio: 0.23 ± 0.91, 0.29 ± 0.11, 0.19 ± 0.06, respectively; p = 0.001), without differences between the histological types of BE. Fifty-four out of the 65 patients with BE were followed up (median of 58.50 months, range 12–113) and 11 of them (20.4%) presented progression to low-grade dysplasia (n = 8) or high-grade dysplasia/adenocarcinoma (n = 3), without differences in the IGF system compared with patients without progression. Patients with BE and esophageal adenocarcinoma have changes in the IGF system although the serological levels of IGF-1 and IGFBP-3 do not correlate with histological progression of BE. El esófago de Barrett (EB) es una entidad con una progresión histológica a malignidad conocida. Los factores de crecimiento insulínico (IGF, de Insulin-Like Growth Factor) están involucrados en la carcinogénesis asociada a la obesidad y se han asociado con el riesgo de padecer algunos tipos de cáncer. Evaluar los niveles serológicos de IGF-1 e IGFBP-3 en pacientes con EB y adenocarcinoma de esófago. Estudio prospectivo de pacientes con EB y adenocarcinoma de esófago explorados con gastroscopia entre Septiembre 2012 y Diciembre 2015 a los que se realizó una extracción de sangre para la determinación de IGF-1 e IGFBP-3. Se incluyó un grupo control. Se incluyeron 116 pacientes: 36 controles, 62 con EB (42 sin displasia y 20 con displasia) y 18 con adenocarcinoma. El IGF-1 y la ratio molar IGF-1/IGFBP-3 presentaron un aumento progresivo en los grupos con EB y adenocarcinoma comparado con los controles (IGF-1: 135.55 ± 66.07 ng/mL, 148.33 ± 81.5 ng/mL, 108.19 ± 46.69 ng/mL, respectivamente; p = 0.049) (ratio molar: 0.23 ± 0.91, 0.29 ± 0.11, 0.19 ± 0.06, respectivamente; p = 0.001), sin diferencias entre los diferentes grados histológicos. 54 de los 65 pacientes con EB fueron seguidos durante una mediana de 58.50 meses (12–113) y 11 de ellos (20.4%) presentaron progresión a displasia de bajo grado (n = 8) o displasia de alto grado/adenocarcinoma (n = 3), sin encontrar diferencias en el sistema IGF comparado con los que no progresaron. los pacientes con EB y adenocarcinoma esofágico presentan cambios en el sistema IGF aunque los niveles de IGF-1 y IGFBP-3 no se correlacionan con la progresión histológica del EB.