Serum Levels of Insulin-like Growth Factor 1 and Insulin-like Growth Factor-binding Protein 2 as a Novel Biomarker in the Detection of Pancreatic Adenocarcinoma

Background: Insulin-like growth factor 1 (IGF-1) and insulin-like growth factor-binding protein 2 (IGFBP-2) are proteins that belong to the IGF axis, which is involved in glucose and lipid metabolism and may as well promote carcinogenesis. Goals: The aim of this study was to evaluate the serum concentration levels of IGF-1 and IGFBP-2 in patients with newly diagnosed pancreatic adenocarcinoma (PDAC) to verify their possible role in the diagnosis of the disease. Study: The study included 69 patients with PDAC and 20 healthy controls. The concentrations of IGF-1 and IGFBP-2 were estimated by means of ELISA. The study protocol was approved by the Bioethics Committee at the Medical University of Lodz in Poland. Results: PDAC patients compared with controls have a significantly lower mean serum IGF-1 level (45.83 +/- 30.03 vs. 70.66 +/- 60.57 ng/mL;P<0.0001). In contrast, in PDAC patients, the mean IGFBP-2 level was significantly higher compared with the control group (225.06 +/- 86.37 vs. 51.92 +/- 29.40 ng/mL;P<0.0001). The results show that, at the 0.01 sensitivity level, the IGF-1/IGFBP-2 ratio <0.85 points indicates PDAC presence. At this level of sensitivity, the test has a specificity of 0.097 (alpha=0.01; beta=0.097; IGF-1/IGFBP-2 <= 0.85). Conclusions: Our results show that IGF-1 to IGFBP-2 ratio <= 0.85 may be a powerful PDAC indicator. Further studies in this area in a larger patient group are necessary to confirm our findings.