Prognostic significance of serum adipokine levels in colorectal cancer patients.
BACKGROUND
Adipokines may significantly influence the growth and proliferation of tumor stroma and malignant cells within. Reduced adiponectin and increased leptin serum levels were found in colorectal cancer (CRC) patients. Recently, it has been demonstrated that tumor necrosis factor-alpha (TNF-alpha) is able to induce dose-dependent changes in serum adipokine levels. Thus, aims of this study were to evaluate the possible associations between adipokines, TNF-alpha and clinicopathological variables of CRC patients and to analyze their possible prognostic value in predicting relapse-free and overall survival.


METHODS
Baseline leptin, adiponectin and TNF-alpha levels were analyzed in 90 patients with histologically diagnosed primary or newly diagnosed metastatic CRC treated at 'Tor Vergata' Clinical Center and followed up for a median period of 3 years.


RESULTS
Serum leptin levels were higher in CRC patients than in controls (p<0.0001). Conversely, serum adiponectin levels were lower in CRC patients than in controls (p<0.0001). Leptin inversely correlated with adiponectin (p<0.005). The leptin/adiponectin (L/A) ratio was eight-fold greater in CRC compared to controls (p<0.0001). Kaplan-Meier analysis of relapse-free and overall survival time showed that the L/A ratio was an independent predictor for adverse outcome in CRC.


CONCLUSIONS
Serum adipokine levels might have a role in the biology of CRC and the combined measurement of leptin and adiponectin levels might provide useful prognostic information in the management of patients with CRC.
Guadagni
Fiorella
F
Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS San Raffaele, Via della Pisana 235, 00163 Rome, Italy. fiorella.guadagni@sanraffaele.it
Roselli
Mario
M
Martini
Francesca
F
Spila
Antonella
A
Riondino
Silvia
S
D'Alessandro
Roberta
R
Del Monte
Girolamo
G
Formica
Vincenzo
V
Laudisi
Anastasia
A
Portarena
Ilaria
I
Palmirotta
Raffaele
R
Ferroni
Patrizia
P
D052242:Adiponectin / Q000097:blood; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020738:Leptin / Q000097:blood; D008113:Liver Neoplasms / Q000097:blood* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000473:pathology / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000097:blood* / Q000556:secondary / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
C499918:ADIPOQ protein, human; D052242:Adiponectin; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha