Abstract: Abstract: Objective　To explore the expression level of insulin-like growth factor binding protein-2 (IGFBP-2) and its correlations to nutritional status and the prognosis of esophageal cancer patients. Methods　A total of 136 esophageal cancer patients treated with surgical resection and chemotherapy/radiotherapy in our hospital were included in this study. The expression level of serum IGFBP-2 was detected by enzyme linked immunosorbent assay (ELISA), and its correlations to clinicopathological characteristics and nutritional parameters were further analyzed. Kaplan-Meier survival curve was plotted to evaluate the impact of serum IGFBP-2 expression on the overall survival (OS) of esophageal cancer patients. Moreover, the Cox multivariate regression analysis was used to determine the prognostic significance of serum IGFBP-2 level for esophageal cancer patients. Results　All patients were divided into the high expression (n=68) group and the low expression group (n=68) based on the median value (302.52 μg/L) of serum IGFBP-2 expression. Compared with the low expression group, patients with high expression of serum IGFBP-2 had a higher proportion of weight loss ≥ 5% (χ2= 6.814), serum albumin <35 g/L (χ2=23.702), C-reactive protein ≥10 mg/L　(χ2= 4.561), Glasgow prognostic score (GPS) 1-2 (χ2= 17.486) and prognostic nutritional index (PNI) <50.8 (χ2= 51.883), and a lower count of peripheral blood lymphocyte (P＜0.05). Kaplan-Meier curves showed that the median OS of patients with high IGFBP-2 expression was significantly shorter than that of patients with low IGFBP-2 expression (22.0 months vs. 36.0 months, Log-rank χ2=5.037，P＜0.05). The results of multivariate Cox analysis indicated that high serum IGFBP-2 expression (HR=1.631, 95%CI: 1.064-2.940, P=0.025) and tumor stage Ⅲ-Ⅳ (HR=1.851, 95%CI: 1.166-2.940, P=0.009) were independent prognostic factors for esophageal cancer patients. Conclusion　The elevated serum level of IGFBP-2 expression is an indicator of malnutrition status, suggesting a poor prognosis of esophageal cancer.

Key words: esophageal neoplasms, insulin-like growth factor binding protein 2, nutritional status, prognosis