Postoperative Serum Levels of sCD26 for Surveillance in Colorectal Cancer Patients
et al. (2014) Postoperative Serum Levels of sCD26 for Surveillance in
Colorectal Cancer Patients. PLoS ONE 9(9): e107470. doi:10.1371/journal.pone.0107470
Postoperative Serum Levels of sCD26 for Surveillance in Colorectal Cancer Patients
Loretta De Chiara 0 1
Ana M. Rodrguez-Pin eiro 0 1
Oscar J. Cordero 0 1
Lidia Va zquez-Tun as 0 1
Daniel Ayude 0 1
Francisco J. Rodrguez-Berrocal 0 1
Mara Pa ez de la Cadena 0 1
Hiromu Suzuki, Sapporo Medical University, Japan
0 Current address: Institute of Biomedicine, University of Gothenburg , Gothenburg , Sweden
1 1 Departamento de Bioqu mica, Gene tica e Inmunolog a, Universidad de Vigo , Vigo, Pontevedra, Spain, 2 Departmento de Bioqu mica y Biolog a Molecular, Edificio CIBUS, Campus Vida , Universidad de Santiago de Compostela , Santiago de Compostela, A Corun a, Spain , 3 Servicio de Oncolog a, Complejo Hospitalario Universitario de Vigo , Vigo, Pontevedra , Spain
One of the main aims of the follow-up after curative resection of colorectal cancer is the early detection and treatment of tumor recurrence. We previously demonstrated decreased preoperative soluble CD26 (sCD26) levels in serum from colorectal cancer patients. We extended now the study to investigate if sCD26 levels in postoperative serum serve as marker of recurrence of the disease during surveillance. Soluble sCD26 was measured in pre- and postoperative serum samples of 43 patients with primary colorectal cancer. Carcinoembryonic antigen, carbohydrate antigen 19.9 and 72.4 levels were also measured during surveillance. The average follow-up period was 41.8620.8 months. sCD26 levels during follow-up showed well-defined patterns in patients without disease (n = 28), and in patients with tumor persistence (n = 2), local recurrence (n = 3) or distant metastasis (n = 10). Disease-free patients showed stable levels between 460-850 ng/mL during follow-up, while high (over 850 ng/mL) and unstable sCD26 levels were found before recurrence was diagnosed. The mean maximum/ minimum sCD26 ratios during surveillance were 1.52, 2.12 and 2.63 for patients with no recurrence, local recurrence and metastasis, respectively (p = 0.005). From the cut-off obtained from a receiver operator characteristics (ROC) curve built with the maximum/minimum sCD26 ratios and the upper and lower cut-offs of sCD26, we were able to discriminate patients with and without recurrent disease. We propose that the measurement of serum sCD26 during the follow-up of patients diagnosed of colorectal cancer could be valuable for the early detection of local and distant recurrence. A large, randomized, prospective trial should be performed to confirm our findings.
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Data Availability: The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper and its
Supporting Information files.
Funding: This work was partially supported by Agrupacio n Estrategica INBIOMED (Investigacio n en Biomedicina) (2012/273 and CN 2011/024), from DXPCTSUG
(Direccio n Xeral de Promocio n Cientfica e Tecnolo xica do Sistema Universitario de Galicia) and FEDER (Fondo Europeo de Desarrollo Regional) funding. LD is
supported by Fundacio n Cientfica de la Asociaci on Espan ola contra el Cancer (GCB13131592CAST). The funders had no role in study design, data collection and
analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
At the time of diagnosis, about 75% of colorectal cancer (CRC)
patients have the tumor confined to a portion of the bowel or to
regional lymph nodes, and can be referred for curative resection.
Unfortunately, 3050% of those patients develop recurrence, 90%
during the first 5 years after treatment [1,2].
One of the aims of the follow-up after curative resection in CRC
patients is to improve the outcome by early detection and
treatment of recurrence. Thus postoperative surveillance must
identify asymptomatic recurrences for the early detection of locally
persistent tumors or metastases, so that further curative treatment
can be initiated and the survival rates improved. Consequently,
surveillance strategies require effective means for identifying
residual or recurrent disease. In general, meta-analyses and
reviews agree that a more intensive follow-up contributes to an
overall survival benefit [18].
Many different methods have been proposed for the follow-up
of CRC patients, which can be subdivided into three categories:
laboratory tests, as determination of carcinoembryonic antigen
(CEA) serum levels, other markers as the carbohydrate antigens
(CA), or liver enzymes; image tests, as ultrasound, X-ray or
computed tomography; and endoscopies. Compared to other
available diagnostic modalities, serial CEA determinations appear
to be the most sensitive for the detection of early recurrent disease
[68]. However, the current serum markers used to detect cancer
recurrence (CEA, TPS, CA-19 (...truncated)