RÉSUMÉ
Objective:To investigate the expressions of vascular endothelial growth factor (VEGF), serum insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) in patients with colorectal cancer liver metastases (CRLM), and diagnostic values of VEGF and IGF-1-to-IGFBP-3 ratio (IGF-1/IGFBP-3).Methods:The clinical data of 41 patients with CRLM (CRLM group), 70 patients with colorectal cancer (CRC group) and 85 patients with colorectal polyp (colorectal polyp group) who were newly diagnosed in Baoji Central Hospital from January 2020 to January 2023 were retrospectively analyzed, while 40 healthy volunteers who had medical checkup in the same period were selected as healthy control group. The level of VEGF was detected by enzyme-linked immunosorbent assay, the levels of serum IGF-1 and IGFBP-3 were detected by chemiluminescence immunoassay, and the results were compared. The efficacy of the above indexes alone and in combination for diagnosing CRLM was assessed using the receiver operating characteristic curve, with pathologic diagnostic results as the gold standard.Results:The levels of VEGF, IGF-1, IGFBP-3 and IGF-1/IGFBP-3 in CRLM group, CRC group, colorectal polyp group and healthy control group decreased in steps, and the differences among different tissues were statistically significant (all P < 0.05). Furthermore, the levels of VEGF, IGF-1, IGFBP-3, IGF-1/IGFBP-3 in CRLM group were higher than those in CRC group, colorectal polyp group and healthy control group, and the differences were statistically significant (all P < 0.05). The levels of VEGF, IGF-1, IGFBP-3 and IGF-1/IGFBP-3 in CRC group were higher than those in colorectal polyp group and healthy control group, and the differences were statistically significant (all P < 0.05). The levels of VEGF, IGF-1, IGFBP-3 and IGF-1/IGFBP-3 in colorectal polyp group were higher than those in healthy control group, and the differences were statistically significant (all P < 0.05). The efficiency analysis of single and combined detection of the serum VEGF, IGF-1/IGFBP-3 for diagnosing CRLM showed that the sensitivity, specificity and accuracy of VEGF, IGF-1/IGFBP-3 and combination of the two were statistically significant ( χ2 values were 6.523, 11.499 and 11.194, all P < 0.05). The optimal cut-off value of VEGF alone for diagnosing CRLM was 326.83 pg/ml, and the optimal cut-off value of IGF-1/IGFBP-3 for diagnosing CRLM was 71.44. The diagnostic sensitivity and area under the curve (AUC) of VEGF alone were lower than those of IGF-1/IGFBP-3 alone, the difference was statistically significant ( P < 0.05), but the specificity and accuracy were higher than those of IGF-1/IGFBP-3, and the difference was statistically significant ( P < 0.05). The sensitivity, specificity, accuracy and AUC of combination of VEGF and IGF-1 and IGF-1/IGFBP-3 for diagnosing CRLM were higher than the single detection of the two, and the differences were statistically significant (all P < 0.05). Conclusions:The serum VEGF, IGF-1 levels and IGF-1/IGFBP-3 are high in CRLM patients, IGFBP-3 level is low in CRLM patients. The detections of these indexes have featured with rapid, accuracy and high sensitivity. Single detection has its own advantages and disadvantages, and the combined detection can complement each other and improve the diagnostic efficiency, which is of high clinical application value for the diagnosis of CRLM.