title: Plasma MIC-1 correlates with systemic inflammation but is not an independent determinant of nutritional status or survival in oesophago-gastric cancer.
abstract: 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.
authors.affiliation: University of Edinburgh, Royal Infirmary of Edinburgh, UK.
authors.forename: R J E
authors.initials: RJ
authors.lastname: Skipworth
authors.forename: D A C
authors.initials: DA
authors.lastname: Deans
authors.forename: B H L
authors.initials: BH
authors.lastname: Tan
authors.forename: K
authors.initials: K
authors.lastname: Sangster
authors.forename: S
authors.initials: S
authors.lastname: Paterson-Brown
authors.forename: D A
authors.initials: DA
authors.lastname: Brown
authors.forename: M
authors.initials: M
authors.lastname: Hunter
authors.forename: S N
authors.initials: SN
authors.lastname: Breit
authors.forename: J A
authors.initials: JA
authors.lastname: Ross
authors.forename: K C H
authors.initials: KC
authors.lastname: Fearon
mesh_terms: 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
chemical_list: C526140:GDF15 protein, human; D055436:Growth Differentiation Factor 15; D018836:Inflammation Mediators