The predictive value of serum IGFBP-3,LMTK3 combined with Gadobenate dimeglumine-enhanced MRI for liver me-tastasis in colorectal cancer patients

LU Lihua; JI Fanghua; LI Guibin

doi:10.20258/j.cnki.1006-9011.2025.12.019

Abstract：Objective To analyze the predictive value of serum insulin-like growth factor binding protein-3(IGFBP-3),le-mur tyrosine kinase-3(LMTK3)combined with Gadobenate dimeglumine-enhanced magnetic resonance imaging(MRI)for liver metastasis in patients with colorectal cancer.Methods 273 patients with colorectal cancer admitted to our hospital were in-cluded as the study subjects.They were separated into a liver metastasis group(n=96)and a non metastasis group(n=177)based on whether liver metastasis occurred using MRIs-enhanced with Modis.ELISA method was applied to detect the levels of serum IGFBP-3 and LMTK3.Kappa consistency was applied to analyze the consistency between gadobenate dimeglumine-enhanced MRI and the three combination results with pathological examination.Receiver operating characteristic curves were plotted to analyze the predictive value of IGFBP-3 and LMTK3 for liver metastasis in colorectal cancer patients.Results Com-pared with the non metastasis group,the serum IGFBP-3 level was prominently lower and the LMTK3 level was prominently higher in the liver metastasis group(all P<0.05).Modis-enhanced MRI predicted liver metastasis in 89 colorectal cancer pa-tients,with 70 confirmed positive and 19 negative by pathological examination.Modris-enhanced MRI predicted liver metastasis in 184 negative cases among colorectal cancer patients,with 26 positive and 158 negative cases confirmed by pathological exami-nation.The Kappa value for Modris-enhanced MRI predicting liver metastasis in colorectal cancer patients was 0.632,demon-strating high consistency with pathological examination(P<0.05).Modis-enhanced MRI combined with serum IGFBP-3 and LMTK3 levels predicted liver metastasis in colorectal cancer patients as follows:of 114 positive cases,4 were positive and 20 negative confirmed by pathological examination.Modis-enhanced MRI combined with serum IGFBP-3 and LMTK3 levels pre-dicted liver metastasis in colorectal cancer patients:160 were negative cases,with 3 positive and 157 negative cases confirmed by pathological examination.The combined prediction of liver metastasis in colorectal cancer patients using contrast-enhanced MRI and serum IGFBP-3 and LMTK3 levels yielded a Kappa value of 0.822,demonstrating extremely high consistency with pathological examination(P<0.05).The area under the curve for diagnosing liver metastasis using IGFBP-3,LMTK3,and MRI was 0.841,0.863,and 0.811,respectively.Combined use significantly outperformed the individual use of IGFBP-3,LMTK3,or MRI for diagnosis(all P<0.05).Conclusion Modified contrast-enhanced MRI combined with serum IGFBP-3 and LMTK3 demonstrates high predictive value for liver metastasis in colorectal cancer patients.