Plasma MIC-1 correlates with systemic inflammation but is not an independent determinant of nutritional status or survival in oesophago-gastric cancer.
BACKGROUND
Macrophage inhibitory cytokine-1(MIC-1) is a potential modulator of systemic inflammation and nutritional depletion, both of which are adverse prognostic factors in oesophago-gastric cancer (OGC).


METHODS
Plasma MIC-1, systemic inflammation (defined as plasma C-reactive protein (CRP) of > or =10 mg l(-1) or modified Glasgow prognostic score (mGPS) of > or =1), and nutritional status were assessed in newly diagnosed OGC patients (n=293). Healthy volunteers (n=35) served as controls.


RESULTS
MIC-1 was elevated in patients (median=1371 pg ml(-1); range 141-39 053) when compared with controls (median=377 pg ml(-1); range 141-3786; P<0.001). Patients with gastric tumours (median=1592 pg ml(-1); range 141-12 643) showed higher MIC-1 concentrations than patients with junctional (median=1337 pg ml(-1); range 383-39 053) and oesophageal tumours (median=1180 pg ml(-1); range 258-31 184; P=0.015). Patients showed a median weight loss of 6.4% (range 0.0-33.4%), and 42% of patients had an mGPS of > or =1 or plasma CRP of > or =10 mg l(-1) (median=9 mg l(-1); range 1-200). MIC-1 correlated positively with disease stage (r(2)=0.217; P<0.001), age (r(2)=0.332; P<0.001), CRP (r(2)=0.314; P<0.001), and mGPS (r(2)=0.336; P<0.001), and negatively with Karnofsky Performance Score (r(2)=-0.269; P<0.001). However, although MIC-1 correlated weakly with dietary intake (r(2)=0.157; P=0.031), it did not correlate with weight loss, BMI, or anthropometry. Patients with MIC-1 levels in the upper quartile showed reduced survival (median=204 days; 95% CI 157-251) when compared with patients with MIC-1 levels in the lower three quartiles (median=316 days; 95% CI 259-373; P=0.036), but MIC-1 was not an independent prognostic indicator.


CONCLUSIONS
There is no independent link between plasma MIC-1 levels and depleted nutritional status or survival in OGC.
Skipworth
R J E
RJ
University of Edinburgh, Royal Infirmary of Edinburgh, UK.
Deans
D A C
DA
Tan
B H L
BH
Sangster
K
K
Paterson-Brown
S
S
Brown
D A
DA
Hunter
M
M
Breit
S N
SN
Ross
J A
JA
Fearon
K C H
KC
D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000097:blood / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology; D005260:Female; D055436:Growth Differentiation Factor 15 / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood*; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009752:Nutritional Status / Q000502:physiology*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000097:blood / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology; D016019:Survival Analysis
C526140:GDF15 protein, human; D055436:Growth Differentiation Factor 15; D018836:Inflammation Mediators