Association between insulin-like growth factor-2 and metastases after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma: a prospective study.

Abstract

BACKGROUND:

Hypoxia up-regulates insulin-like growth factor-2 (IGF-2) and thus stimulates the growth of hepatocellular carcinoma (HCC) cells. In the current study, the authors prospectively evaluated changes in plasma IGF-2 levels in HCC patients after transcatheter arterial chemoembolization (TACE), which usually results in hypoxic insult to liver tissue. The authors also examined the association between changes in plasma IGF-2 levels after TACE and HCC progression, especially in relation to metastasis.

METHODS:

Plasma IGF-2 levels were measured before and 4 weeks after TACE in 46 patients with HCC. Three months after TACE, the patients were evaluated for the occurrence of metastatic HCC.

RESULTS:

In 13 of the 46 patients, post-TACE plasma IGF-2 levels decreased by > 20% (Group 1) compared with their basal levels; in 18 patients, the IGF-2 levels changed within 20% (Group 2) and in 15 patients the IGF-2 levels increased by > 20% (Group 3). Plasma IGF-2 levels had a tendency to increase in patients with large-sized tumors, high serum alpha-fetoprotein (AFP) levels, and the heterogeneous uptake of iodized oil. Metastatic foci were found in 9 patients in Group 3 (60%), in contrast to only 3 patients in Group 2 (17%) and in none of the patients in Group 1 (P = 0.001). On multivariate analysis, higher Child-Pugh scores and increased plasma IGF-2 levels (Group 3) were found to be independent risk factors for metastasis.

CONCLUSIONS:

Increased plasma IGF-2 levels after TACE, which are common in patients with large-sized tumors and high serum AFP levels, appear to be associated with the occurrence of metastatic HCC after TACE.

• Authors: B C Song, Y H Chung, J A Kim, H C Lee, H K Yoon, K B Sung, S H Yang, K Yoo, Y S Lee, D J Suh
• Journal: Cancer (Cancer) Vol. 91 Issue 12 Pg. 2386-93 (Jun 15 2001) ISSN: 0008-543X [Print] United States
• PMID: 11413529 (Publication Type: Journal Article)
• Copyright: Copyright 2001 American Cancer Society.

Chemical References

• alpha-Fetoproteins
• Insulin-Like Growth Factor II

Topics

• Carcinoma, Hepatocellular (pathology, therapy)
• Embolization, Therapeutic
• Female
• Humans
• Insulin-Like Growth Factor II (analysis)
• Liver Neoplasms (pathology, therapy)
• Male
• Middle Aged
• Neoplasm Metastasis
• Prospective Studies
• alpha-Fetoproteins (analysis)