Circulating cell death products predict clinical outcome of colorectal cancer patientsReportar como inadecuado

Circulating cell death products predict clinical outcome of colorectal cancer patients - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Cancer

, 9:88

First Online: 23 March 2009Received: 17 December 2008Accepted: 23 March 2009DOI: 10.1186-1471-2407-9-88

Cite this article as: Koelink, P.J., Lamers, C.B., Hommes, D.W. et al. BMC Cancer 2009 9: 88. doi:10.1186-1471-2407-9-88


BackgroundTumor cell death generates products that can be measured in the circulation of cancer patients. CK18-Asp396 M30 antigen is a caspase-degraded product of cytokeratin 18 CK18, produced by apoptotic epithelial cells, and is elevated in breast and lung cancer patients.

MethodsWe determined the CK18-Asp396 and total CK18 levels in plasma of 49 colorectal cancer patients, before and after surgical resection of the tumor, by ELISA. Correlations with patient and tumor characteristics were determined by Kruskal-Wallis H and Mann-Whitney U tests. Disease-free survival was determined using Kaplan-Meier methodology with Log Rank tests, and univariate and multivariate Cox proportional hazard analysis.

ResultsPlasma CK18-Asp396 and total CK18 levels in colorectal cancer patients were related to disease stage and tumor diameter, and were predictive of disease-free survival, independent of disease-stage, with hazard ratios HR of patients with high levels > median compared to those with low levels ≤ median of 3.58 95% CI: 1.17–11.02 and 3.58 95% CI: 0.97–7.71, respectively. The CK18-Asp396-CK18 ratio, which decreased with tumor progression, was also predictive of disease-free survival, with a low ratio ≤ median associated with worse disease-free survival: HR 2.78 95% CI: 1.06–7.19. Remarkably, the plasma CK18-Asp396 and total CK18 levels after surgical removal of the tumor were also predictive of disease-free survival, with patients with high levels having a HR of 3.78 95% CI: 0.77–18.50 and 4.12 95% CI: 0.84–20.34, respectively, indicating that these parameters can be used also to monitor patients after surgery.

ConclusionCK18-Asp396 and total CK18 levels in the circulation of colorectal cancer patients are predictive of tumor progression and prognosis and might be helpful for treatment selection and monitoring of these patients.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-9-88 contains supplementary material, which is available to authorized users.

Download fulltext PDF

Autor: Pim J Koelink - Cornelis BHW Lamers - Daan W Hommes - Hein W Verspaget


Documentos relacionados