Abstract
PurposePrevious studies have supported an association between serum insulin-like growth factor-1 (IGF1) and IGF-binding protein 3 (IGFBP3) levels and hepatocellular carcinoma (HCC), but the results were inaccurate. It has recently been proposed that IGF1 and IGFBP3 play roles in the time-to-progression (TTP) and overall survival (OS) of HCC patients. Our results revealed that serum IGF1 level is predictive of the progression and survival of HCC patients.ResultsHCC was associated with a significant reduction in serum IGF-1 and IGFBP-3 levels compared to cirrhosis (p = 0.037). Low serum IGF1 levels were predictive of a shorter TTP (OR, 2.74; 95% confidence interval [CI], 1.92–3.90) and poorer OS (odds ratio [OR], 2.20; 95% CI, 1.81–2.68) in HCC patients. The IGF1/IGFBP3 molar ratio was not significantly associated with the risk of HCC (OR, 1.311; 95% CI, 0.761–2.260).Materials and MethodsWe conducted a comprehensive literature search in PubMed, EMBASE, and the Cochrane Library. Twenty studies met the inclusion criteria and were subjected to statistical analysis. The geometric mean and standard deviation (SD) of serum IGF1 and IGFBP3 levels in the healthy, cirrhosis, and HCC groups were calculated. Pooled odds ratios (ORs) were calculated using a fixed-effects model to analyse the association of serum IGF1 level with the progression and survival of HCC patients.ConclusionsSerum IGF1 and IGFBP3 levels were positively associated with the incidence of HCC. Serum IGF1 level is an independent prognostic factor for the progression and survival of HCC patients.
Highlights
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide
HCC was associated with a significant reduction in serum IGF-1 and IGFBP-3 levels compared to cirrhosis (p = 0.037)
Low serum insulin-like growth factor-1 (IGF1) levels were predictive of a shorter TTP (OR, 2.74; 95% confidence interval [CI], 1.92–3.90) and poorer overall survival (OS) in HCC patients
Summary
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. Insulin-like growth factor-1 (IGF1), which is synthesised by the liver, is an important regulator of cellular proliferation, differentiation and apoptosis [7,8,9] These effects can be inhibited by IGFBP3, which binds to and prevents IGFI from binding to type 1 insulinlike growth factor receptor (IGFI-R) [10]. Low baseline serum IGF1 levels are reportedly associated with shorter time-to-progression (TTP) and poorer overall survival (OS) in patients with HCC, irrespective of the grade of hepatic dysfunction [15, 16]. These studies were hampered by their low quality and small sample sizes. We performed a systematic review and meta-analysis of 20 studies to investigate the associations of IGF1 components with HCC and to examine their ability to predict the survival and prognosis of HCC patients
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