Prognostic significance of elevated endothelin-1 levels in patients with colorectal cancer

• Published in: The International journal of biological markers Vol. 19; no. 1; pp. 32 - 37
• Main Authors: ARUN, C, LONDON, N. J. M, HEMINGWAY, D. M
• Format: Journal Article
• Language: English
• Published: Milano Wichtig 2004
• Subjects: Aged; Analytical, structural and metabolic biochemistry; Biological and medical sciences; Biomarkers, Tumor - blood; Colorectal Neoplasms - blood; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - pathology; Endothelin-1 - blood; Enzyme-Linked Immunosorbent Assay; Female; Fundamental and applied biological sciences. Psychology; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Neoplasm Metastasis; Prognosis; Proportional Hazards Models; Prospective Studies; Time Factors; Colonic disease; Human; Rectal disease; Prognosis; Clinical biology; Colorectal cancer; Digestive diseases; Intestinal disease; Biochemistry; Endothelin 1; Malignant tumor; Molecular biology
• ISSN: 0393-6155; 1724-6008
• DOI: 10.1177/172460080401900104

Prognostic factors from clinical, laboratory and pathological data of patients with colorectal cancer are essential to identify high-risk groups to whom beneficial adjuvant therapy could be given. Endothelin-1, a growth factor, has been associated with the development and spread of solid tumours. This prospective study was performed to determine whether preoperative plasma big ET-1 levels might be useful as a prognostic indicator in patients with colorectal carcinoma. Sixty-five consecutive patients with colorectal cancer confirmed by biopsy were included prospectively into this study over a 12-month period. Plasma samples from a peripheral vein were obtained prior to surgery. Univariate analysis of survival using age (< or > 70 years), sex, Dukes' stage (A&B versus C), tumour size (< or > 50 mm), vascular invasion and plasma big ET-1 levels was performed and significant factors were then analysed with the Cox regression model. Three variables, age, Dukes' tumour stage and plasma big ET-1 levels, were found to have prognostic significance (p<0.05). Factors associated with a poorer prognosis were age >70 years (p=0.02), Dukes' C tumours (p=0.04) and plasma big ET-1 levels >4.2 pg/mL (p=0.02). The Cox regression model identified the same three variables as having independent prognostic value for overall survival. Preoperative plasma big ET-1 levels may be useful in predicting overall survival in patients with colorectal cancer. Plasma big ET-1 levels may be useful in the selection of high-risk lymph node-negative patients with colorectal cancer for adjuvant therapy.