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. 2017 Jul 12;8(46):81098-81108.
doi: 10.18632/oncotarget.19186. eCollection 2017 Oct 6.

Serum insulin-like growth factor-1 and its binding protein 3 as prognostic factors for the incidence, progression, and outcome of hepatocellular carcinoma: a systematic review and meta-analysis

Jing Wang #  1 , Yu-Chuan Li #  2 , Min Deng  2 , Hai-Yin Jiang  2 , Li-Hua Guo  2 , Wen-Juan Zhou  3 , Bing Ruan  2
Affiliations

Serum insulin-like growth factor-1 and its binding protein 3 as prognostic factors for the incidence, progression, and outcome of hepatocellular carcinoma: a systematic review and meta-analysis

Jing Wang et al. Oncotarget. .

Abstract

Purpose: Previous 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.

Results: HCC 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 methods: We 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.

Conclusions: Serum 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.

Keywords: IGF-binding protein-3; hepatocellular carcinomas; insulin-like growth factor-1; overall survival; time-to-progression.

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Conflict of interest statement

CONFLICTS OF INTEREST The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.

Figures

Figure 1
Figure 1. Flow chart of the studies selected for systematic review and meta-analysis
Figure 2
Figure 2. Association between serum IGF1 level and HCC
(A) Overall survival (OS); (B) time-to-progression (TTP).
Figure 3
Figure 3. Publication bias in studies of the association between serum IGF1 level and overall survival of HCC patients
See this image and copyright information in PMC

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