Open surgery induces a dramatic decrease in circulating intact IGFBP-3 in patients with colorectal cancer not seen...

Area of Science:

• Oncology
• Biochemistry
• Surgical Science

Background:

• Open surgery (OS) decreases plasma insulin-like growth factor-binding protein 3 (IGFBP-3) postoperatively, unlike laparoscopic surgery (LS).
• Intact IGFBP-3 possesses tumor-suppressive properties, whereas its degradation products lack this function.
• Standard ELISA methods cannot differentiate between intact IGFBP-3 and its degradation products.

Purpose of the Study:

• To precisely quantify plasma levels of intact IGFBP-3 on postoperative day 2 (POD2) after open and laparoscopic colorectal cancer resection (stage I-III).
• To investigate the differential impact of open versus minimally invasive surgery on intact IGFBP-3 concentrations.

Main Methods:

• A cohort of 15 OS patients and 16 LS patients undergoing colorectal cancer resection (stage I-III) were included.
• Plasma samples were collected preoperatively and on POD2.
• A novel combined Western blot and ELISA method was employed to determine intact IGFBP-3 levels.

Main Results:

• In OS patients, intact IGFBP-3 levels decreased dramatically from a preoperative mean of 1920 +/- 1430 ng/ml to 355 +/- 545 ng/ml on POD2 (p < 0.005).
• In LS patients, no significant difference was observed between preoperative (1305 +/- 807 ng/ml) and POD2 (922 +/- 714 ng/ml) intact IGFBP-3 levels.

Conclusions:

• Open colorectal cancer resection leads to a significant reduction in intact IGFBP-3 concentration.
• This decrease in intact IGFBP-3 following open surgery may be linked to colon cancer recurrence.
• Laparoscopic surgery preserves intact IGFBP-3 levels, highlighting its potential advantage in managing colorectal cancer patients.