Preoperative insulin-like growth factor-binding protein-3 (IGFBP-3) blood level predicts gleason sum upgrading

Daniela Terracciano, Dario Bruzzese, Matteo Ferro, Claudia Mazzarella, Giuseppe Di Lorenzo, Vincenzo Altieri, Angela Mariano, Vincenzo MacChia, Angelina Di Carlo

Research output: Contribution to journalArticlepeer-review


BACKGROUND About 43% of men with low Gleason grade prostate cancer (PCa) at biopsy will be finally diagnosed with high-grade PCa at radical prostatectomy (RP). Gleason sum at RP is a good indicator of biochemical recurrence and poor clinical outcome. Therefore, there is a need to improve clinical evaluation of PCa aggressiveness in order to choice appropriate treatment. To this aim an easy-available tool is represented by circulating biomarkers. Among these, the best candidates are some molecules involved in PCa pathogenesis such as IGFBP-2 and IGFBP-3, IL-6, and its soluble receptor (SIL-6R). METHODS In this study, we evaluated the ability of preoperative IGFBP-2, IGFBP-3, IL-6, and SIL-6R serum levels to predict Gleason score upgrade in 52 PCa patients. RESULTS We found that IGFBP-3 median levels were significantly lower in patients who showed Gleason upgrading from biopsy to RP (P = 0.024). We also found an association between biopsy T-stage and Gleason Upgrade (P = 0.011). Using multivariate logistic regression model, we demonstrated that the association of IGFBP-3 serum levels together with biopsy T-stage and biopsy Gleason score was useful to calculate a prognostic risk score. ROC curve analysis of risk score showed a good ability to predict GSU (AUC = 0.81; 95% CI 0.69-0.93). CONCLUSIONS Our results suggest that preoperative IGFBP-3 circulating levels determination may be useful to predict Gleason score upgrading alone and/or in combination with biopsy T-stage and biopsy Gleason score.

Original languageEnglish
Pages (from-to)100-107
Number of pages8
Issue number1
Publication statusPublished - Jan 2012


  • Gleason upgrading
  • IGFBP-2
  • IGFBP-3
  • IL-6
  • PSA
  • sIL-6R

ASJC Scopus subject areas

  • Urology
  • Oncology


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