Prostate Cancer IGF-II Serum Levels Increase Discrimination Between Benign Prostatic Hyperplasia and Prostate Cancer and Improve the Predictive Value of PSA in Clinical Staging Lutz Trojan a, *, Christian Bode a , Christel Weiss b , Doris Mayer c , Rainer Grobholz d , Peter Alken a , Maurice Stephan Michel a a Department of Urology, University Hospital Mannheim, Heidelberg University, Germany b Department of Medical Biometrics and Statistics, University Hospital Mannheim, Heidelberg University, Germany c Research Group ‘‘Hormones and Signal Transduction’’, Deutsches Krebsforschungszentrum, Heidelberg, Germany d Department of Pathology, University Hospital Mannheim, Heidelberg University, Germany european urology 49 (2006) 286–292 available at www.sciencedirect.com journal homepage: www.europeanurology.com Article info Article history: Accepted August 18, 2005 Published online ahead of print on December 7, 2005 Keywords: Biological markers Insulin-like Growth factor II Prostate-speciﬁc antigen Prostatic neoplasms Prostatic hyperplasia Abstract Purpose: IGF-I serum levels have been demonstrated as being associated with prostate cancer (PCa) and can serve as a predictive factor for the risk of PCa development. However, the role of IGF-II in PCa and its impor- tance as a predictive marker is still unclear. Our aim was to determine PSA and IGF-II serum levels in patients with PCa and benign prostatic hyperplasia (BPH) and to analyse the value of IGF-II as an additional predictive factor in the diagnostics of PCa. Methods: 112 patients who underwent surgery for BPH or PCa (no hor- monal treatment, no further malignancies) were included in this study ((I) 38 PCa, PSA  15 ng/ml; (II) 34 PCa, PSA > 15 ng/ml; (III) 40 BPH). Preoperative serum levels of total PSA and total IGF-II were determined by ELFA and ELISA, respectively. Results: PSA levels were (I) 5.7  1.9 ng/ml; (II) 25.0  11.5 ng/ml and (III) 4.0  2.8 ng/ml. (II) was statistically associated with a high grading (2b/3; p = 0.0182), a high Gleason sum score (7–10; p = 0.0049) and a non-organ conﬁned tumor (T3/4; p = 0.0009) compared to (I), all Chi 2 test. IGF-II levels were signiﬁcantly higher in PCa (I + II) compared to BPH (833.8  238.9 ng/ml vs. 633.3  141.4 ng/ml, p < 0.0001, t-test). Both PSA and IGF-II were associated with tumor staging ( p = 0.0097, p = 0.0308; t-test). No signiﬁcant correlation was observed between PSA and IGF-II levels. Logistic regression analysis revealed that the combination of PSA and IGF-II improves the prediction of tumor staging * Corresponding author. Department of Urology, University Hospital Mannheim, 68167 Mannheim, Germany. Tel. +49 621 3832629; Fax: +49 621 3831452. E-mail address: lutz.trojan@uro.ma.uni-heidelberg.de (L. Trojan). 0302-2838/$ – see front matter # 2005 Elsevier B.V. All rights reserved. doi:10.1016/j.eururo.2005.08.022