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

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Abstract

Background

As shown earlier by the authors via Western blot analysis, open (OS) but not laparoscopic surgery (LS) induces a qualitative decrease in plasma insulin-like growth factor–binding protein 3 (IGFBP-3) levels on postoperative day 1 (POD 1). Intact IGFBP-3 has tumor suppressive effects, but its degradation products do not. Enzyme linked immunoassay (ELISA) inevitably measures both. In this study, using a novel combined Western blot and ELISA analysis method, precise plasma levels of intact IGFBP-3 on POD2 after open and closed colorectal cancer resection (stage I–III) were determined.

Methods

This study included 15 OS patients with a mean incision length of 26.7 ± 15.5 cm and 16 LS patients with a mean incision length of 5.3 ± 3.1 cm. Intact IGFBP-3 levels were determined via ELISA and Western blot analysis in plasma collected preoperatively and postoperatively.

Results

In the OS patients, the mean preoperative concentration of intact 43–45 kDa IGFBP-3 protein was 1920 ± 1430 ng/ml. It decreased dramatically on POD2 to 355 ± 545 ng/ml (p < 0.005). In the LS group, no significant difference was noted between the preoperative level (1305 ± 807 ng/ml) and the POD2 level (922 + 714 ng/ml).

Conclusions

Open cancer resection, unlike its minimally invasive alternative, induces a dramatic decrease in concentration of intact IGFBP-3, which may have important implications with regard to colon cancer recurrence.

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Authors and Affiliations

  1. Department of Surgery, College of Physicians and Surgeons of Columbia University, 630 West 168th Street, New York, NY, 10032, USA

    I. Kirman, V. Cekic, N. Poltoratskaia, P. Sylla, S. Jain, K. A. Forde & R. L. Whelan

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  1. I. Kirman
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  2. V. Cekic
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  3. N. Poltoratskaia
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  4. P. Sylla
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  5. S. Jain
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  6. K. A. Forde
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  7. R. L. Whelan
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Correspondence to I. Kirman.

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Kirman, I., Cekic, V., Poltoratskaia, N. et al. Open surgery induces a dramatic decrease in circulating intact IGFBP-3 in patients with colorectal cancer not seen with laparoscopic surgery. Surg Endosc 19, 55–59 (2005). https://doi.org/10.1007/s00464-004-8906-x

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  • DOI: https://doi.org/10.1007/s00464-004-8906-x

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