卵巢癌患者围手术期血清胰岛素样生长因子-2和胰岛素样生长因子结合蛋白-3检测的临床意义

目的探讨卵巢癌患者围手术期血清胰岛素样生长因子-2（IGF-2）和胰岛素样生长因子结合蛋白-3（IGFBP-3）的变化及其临床意义。方法采用酶联吸附免疫法（ELISA）测定40例健康对照组及82例卵巢癌患者手术前后血清IGF-2和IGFBP-3的水平，观察健康对照组与卵巢癌患者手术前后血清IGF-2和IGFBP-3的水平变化，分析卵巢癌病人血清IGF-2和IGFBP-3水平与临床特征的关系。结果卵巢癌手术前病人血清IGF．2及IGFBP-3水平明高于正常对照组[（101．5±22．2）ne／ml，（49．3±15．6）ng／mlvs（69．6±17．7）ng／ml，（23．9±11．3）rig／ml，t=3．74，2．85，P〈0．05]；卵巢癌病人有淋巴结转移者血清IGF-2水平[（109．4±20．0）rig／m1]高于无淋巴结转移者[（89．9±16．6）ng／frll]（t’=4．10，P〈0．05），而IGFBP-3水平[（39．8±11．1）ng／m1]低于无淋巴结转移者[（55．8±19．2）ng／m1]（t’=4．49，P〈0．05）；肿瘤临床TNM分期中III—IV期者血清IGF-2水平[（107．5±24．0）ng／m1]高于I—II期者[（91．6±17．7）ng／m1]（t=2．83，P〈0．05），而IGFBP-3水平[（41．7±16．9）ng／m1]低于I～II期者[（56．9±19．1）ng／m1]（t=2．37，P〈0．05），根治性手术组病人术后IGF-2及ICFBP-3水平明显低于术前[（103．4±27．2）ng／ml，（50．2±16．6）ng／mlvs（86．6±12．3）ng／IIll，（41．1±17．1）ng／ml，f=2．48，3．32，P〈0．05]，姑息性手术组病人术前术后血清IGF-2及IGFBP．3水平无明显变化（P〉0．05）。根治性手术组病人术后血清IGF-2及IGFBP-3水平低于姑息性手术组术后[（86．6±12．3）ng／ml，（41．1±17．1）ng／mlvs（103．2±26．0）rig／ml，（45．3±14．9）ng／ml，t’=3．46，t=2．67，P〈0．05]。结论卵巢癌患者血清IGF-2和IGFBP-3的水平与肿瘤的浸润转移、临床分期及根治性手术有关，动态检测卵巢癌患者血清IGF-2和IGFBP-3的变化，有助于估计患者的预后。

Clinical significance of serum IGF-2 and IGFBP-3 in perioperative period patients with ovarian cancer

Objective To investigate the changes of serum insulin-like growth factor-2 (IGF-2) and insulin-link growth factor binding protein-3(IGFBP-3) in the patients with ovarian cancer before and after operation,and evaluate their clinical significance.Methods The contents of serum IGF-2 and IGFBP-3 in 82 patients with ovarian cancer were detected by ELISA before and after operation and compared with that in health controls.Results The contents of IGF-2 in the patients before operation were significantly higher than that in control group[(101.5±22.2)ng/ml,(49.3±15.6)ng/ml vs (69.6±17.7)ng/ml,(23.9±11.3)ng/ml,t＝3.74,2.85,P＜0.05].The contents of IGFBP-3[(39.8±11.1)ng/ml]in the patients before operation were significantly lower than that in control group[(55.8±19.2)ng/ml](t′＝4.49,P＜0.05).There was significant correlation between the contents with lymph node metastasis and clinical stage[(107.5±24.0)ng/ml,(41.7±16.9)ng/ml vs (91.6±17.7)ng/ml,(56.9±19.1)ng/ml;(103.4±27.2)ng/ml,(50.2±16.6)ng/ml vs (86.6±12.3)ng/ml,(41.1±17.1)ng/ml,t＝2.83,2.37,2.48,3.32,P＜0.05).The contents of IGF-2 was significantly decreased,and IGFBP-3 was significantly increased in patients after radical operation [(86.6±12.3)ng/ml,(41.1±17.1)ng/ml vs (103.2±26.0)ng/ml,(45.3±14.9)ng/ml,t′＝3.46,t＝2.67,P＜0.05].But there was no significant difference on the level of IGF-2 and IGFBP-3 before and after palliative resection(P＞0.05).Conclusions The contents of serum IGF-2 and IGFBP-3 are closely related to tumor invasion,metastasis and clinical stage.Dynamic determination of the contents of serum IGF-2 and IGFBP-3 may be an important index for evaluation of invasion,metastasis,efficacy and prognosis for the patients with ovarian cancer.