Clinical significance of serum gastrin levels in patients with colorectal cancer.
OBJECTIVE
An association between elevated serum gastrin levels and the presence of human colorectal cancer has been reported, and gastrin has been shown to stimulate the growth of experimentally induced colon neoplasia. The aim of this study was to determine the preoperative and postoperative concentrations of serum gastrin in 53 patients with colorectal cancer and to assess the correlation between gastrin levels and tumor characteristics and prognosis.


METHODS
A prospective study was performed over a six-year period during which 53 patients received potentially curative surgery for colorectal cancer. The prognostic variables used for the analysis included age, sex, tumor site, stage and degree of differentiation, preoperative and postoperative serum values of carcinoembryonic antigen (CEA) and gastrin, cancer-related mortality, and survival. CEA and gastrin serum values were determined using radioimmunological methods. Follow-up was carried out with clinical and radiological tests.


RESULTS
The mean preoperative gastrin concentration was 51.2+/-27.4 pg/mL (range 12-146). Significantly increased serum gastrin concentrations, which returned to normal after surgery, were detected only in patients with well-differentiated cancer (74.2+/-28.3 pg/mL; moderately differentiated, 52.1+/-23.8; poorly differentiated, 29.9+/-12.3, p=0.02). The prognosis was unrelated to serum gastrin level; instead, tumor stage, preoperative CEA value, and degree of differentiation affected patient survival.


CONCLUSIONS
This study showed that the serum gastrin concentration is not an appropriate clinical oncogenic factor. Although occurring only in well-differentiated tumors, serum gastrin is unrelated to the prognosis of patients with colorectal cancer.
Tocchi
A
A
First Surgical Department, University of Rome La Sapienza Medical School, Rome, Italy. adriano.tocchi@uniroma1.it
Mazzoni
G
G
Puma
F
F
Miccini
M
M
Daddi
G
G
Bettelli
E
E
Cassini
D
D
Brozzetti
S
S
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood; D002454:Cell Differentiation; D015179:Colorectal Neoplasms / Q000097:blood* / Q000175:diagnosis; D005260:Female; D019886:Gastrin-Releasing Peptide / Q000235:genetics; D005755:Gastrins / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018004:Receptors, Bombesin / Q000235:genetics
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D005755:Gastrins; D018004:Receptors, Bombesin; D019886:Gastrin-Releasing Peptide