Prognostic significance of growth hormoneinsulin like growth factor-1insulin axis in colorectal carcinoma

Abstract EN

Background Insulin, insulin like growth factor (IGF) system, and growth hormone (GH) play an important role in the development, proliferation, differentiation, survival, metabolism, and transformation.

Aim of the work This study aimed to explore the relation between insulin, IGF-1, GH and the common prognostic factors in colorectal cancer.

Subjects and methods The study included 47 subjects (30 colorectal cancer patients and 17 healthy volunteers).

Serum insulin and GH were detected by immunoradiometric assay (IRMA) while, IGF-1 was detected using radioimmunoassay (RIA).

Results : Circulating IGF-1, insulin, and GH significantly increased in patients with colorectal (CR) neoplasms than controls.

IGF-1 showed the highest diagnostic performance at cut off value of 116.5 ng / ml (area under the ROC curve = 0.993, p = 0.000).

A significant decrease in GH was achieved by surgical intervention (p = 0.03).

A stage dependent-significant increase was detected with IGF-1 (p = 0.02).

IGF-1 significantly decreased) p = 0.02) with poorly differentiated tumors while GH significantly increased (p = 0.01).

Insignificant negative correlation was observed between IGF-1 and each of GH and insulin reflecting failure of their feedback mechanism/resistance and/or immunomodulation status.

Conclusion : As the prognosis of patients is predominantly influenced by the anatomic extent of cancer and histologic grade, these results, provide evidence of the prognostic role of GH / IGF-1 axis in CR neoplasms.