Pre- and postoperative levels in serum of mannan-binding lectin associated serine protease-2 -a prognostic marker in colorectal cancer.
Mannan-binding lectin-associated serine protease-2 (MASP-2) is the initiating enzyme of the lectin pathway of complement activation. High preoperative serum levels of MASP-2 are associated with recurrence and poor survival in patients with colorectal cancer (CRC). In this study we investigate the prognostic role of MASP-2 in patients curatively resected for primary CRC. Serum concentrations of MASP-2 were determined in 281 patients prior to surgery and 7 months postoperatively using a time-resolved immunofluorometric assay. End points were recurrent cancer and death within a median follow-up time of 7.9 years. The correlation between pre- and postoperative levels was 0.49. High postoperative levels of MASP-2 were significantly associated with poor survival [p = 0.04; hazard ratio (HR) = 1.35; 95% confidence interval (CI), 1.02-1.80] and recurrence (p = 0.01, HR = 1.6, 95% CI, 1.1-1.6). The inclusion of age, gender, tumor localization, and Dukes stage in multivariate analysis demonstrated that high MASP-2 levels were independently predictive of survival (p = 0.01; HR = 1.5, 95% CI, 1.1-2.0) and recurrence (p = 0.01, HR = 1.6; 95% CI, 1.1-2.4). Combining pre- and postoperative MASP-2 levels did not improve the prediction of survival/recurrence. High postoperative levels of MASP-2 are associated with poor prognosis in patients curatively resected for CRC. A change of the MASP-2 level from preoperative levels was not, per se, predictive of recurrent disease or survival.
Ytting
Henriette
H
Department of Surgical Gastroenterology, Hvidovre University Hospital, Kettegaard Allé 30, 2650 Hvidovre, Denmark. ytting@dadlnet.dk
Christensen
Ib Jarle
IJ
Thiel
Steffen
S
Jensenius
Jens Christian
JC
Nielsen
Hans Jørgen
HJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen / Q000097:blood; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000097:blood / Q000201:enzymology* / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D050606:Mannose-Binding Protein-Associated Serine Proteases / Q000378:metabolism*; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012737:Sex Factors; D012984:Software; D016019:Survival Analysis
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; C105296:MASP2 protein, human; D050606:Mannose-Binding Protein-Associated Serine Proteases