Parameters of biological activity in colorectal cancer

The aim of this study was to measure several parameters in patients with early-stage colorectal cancer (CRC) and to evaluate them for their utility in routine clinical practice.

Pre-operative serum levels of the following parameters were measured in 174 patients with CRC (clinical stage I-III): carcinoembryonic antigen (CEA), carbohydrate antigen CA 19-9, proliferative marker thymidine kinase (TK), tissue polypeptide antigen (TPA), tissue polypeptide-specific antigen (TPS), interleukin-6 (IL-6), interleukin-10 (IL-10), matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), vascular endothelial growth factor (VEGF), C-peptide, insulin, adiponectin and leptin. The control group consisted of 50 patients who were undergoing a complete preventive medical examination and in these patients at the time of blood collection there was no evidence of any cancer disease.

Significant increase of the following parameters was found in patients with CRC: CEA, CA 19-9, TPA, IL-6, IL-10, TIMP-1, C-peptide, insulin and adiponectin. Only two of these, CA 19-9 and adiponectin, represent highly unfavorable prognostic factors. If elevated, they affect both progression-free interval and overall survival.

Based on our results, we can conclude that none of the measured parameters fulfills the criteria for use for screening nor for primary diagnosis of CRC. Some of the parameters are important for prognosis estimate: Elevated CA 19-9 is related to an unfavorable prognosis, in terms of cancer recurrence and mortality rate. Angiogenetic factor VEGF represents a prognostic factor important for OS. CEA represents a parameter which is related to disease progression. Interleukins seem to be prospective complementary tumor markers. Adiponectin may be used for estimation of advanced stage of cancer and for estimate of risk of cancer recurrence.