Serum IGF-1, IGF-2 and IGFBP-3 as parameters in the assessment of liver dysfunction in patients with hepatic cirrhosis and in the diagnosis of hepatocellular carcinoma.

摘要

BACKGROUND/AIMS: Insulin like growth factor system becomes impaired in liver cirrhosis. Hepatocellular carcinoma (HCC) is associated with altered synthesis and secretion of several growth factors. METHODOLOGY: Studying the relation between serum levels of IGF-I, IGF-II and IGFBP-3 and clinical grades of liver disease according to Child-Pugh (C-P) score. Also, evaluation of their role in the diagnosis of HCC. IGF-I, IGF-II and IGFBP-3 were measured in 20 healthy subjects, 60 liver cirrhosis patients and 20 HCC patients included in the study. RESULTS: IGF-I, IGF-II and IGFBP-3 levels were significantly lower in cirrhotic patients compared to the healthy subjects and were correlated with the degree of liver dysfunction. IGF-I and IGFBP-3 levels in patients with HCC were significantly lower than in both healthy subjects and in patients with liver cirrhosis. Both IGF-II and AFP levels in HCC were significantly higher than in healthy subjects and in patients with liver cirrhosis. CONCLUSIONS: Estimation of serum IGF-I, IGF-II and IGFBP-3 together with C-P score is more effective in predicting hepatic dysfunction and its severity than C-P score alone. Serum IGF-II level can be used as a serological marker to discriminate HCC from cirrhosis.