title: The relation of the level of serum anti-TF, -Tn and -alpha-Gal IgG to survival in gastrointestinal cancer patients.
abstract: OBJECTIVE
  To evaluate the relation of the level of serum anti-TF, -Tn and -αGal carbohydrate antibodies to survival in gastrointestinal cancer patients.
  
  
  METHODS
  The level of anti-TF (Thomsen-Friedenreich antigen), -Tn and -αGal IgG was analysed in the serum of patients with gastric (n = 83) and colorectal (n = 51) cancers in the long-term follow-up, using ELISA with polyacrylamide glycoconjugates. To evaluate overall survival and the risk of death, the Kaplan-Meier method and the Cox proportional hazards model were used in the univariate analysis of patients groups.
  
  
  RESULTS
  A significantly better survival was observed: (1) in patients with an increased level of anti-TF antibodies (all, stage III, T2-4, N1-2 and G3; P = 0.004-0.038, HR = 0.16-0.46); and (2) in patients with an increased level of anti-Tn antibodies (G1-2 tumors; P = 0.034-0.042, HR = 0.34-0.47). A significantly worse survival was observed in gastrointestinal, gastric and colorectal groups with an increased level of serum anti-αGal antibodies. This association depended on the patho-morphology of tumors (all, stages I-II, III, T2-4, N0, N1-2 and G1-2; P = 0.006-0.048, HR = 1.99-2.33). In the combined assessment of the anti-TF and -αGal antibodies level of the whole gastrointestinal group (n = 53), P = 0.002, HR = 0.25, 95% CI 0.094-0.655. In the follow-up, the survival time was shorter in patients whose level of anti-αGal antibodies rose (P = 0.009-0.040, HR = 2.18-4.27). The level of anti-TF antibodies inversely correlated with neutrophil/lymphocyte ratio (NLR, r = - 0.401, P = 0.004, n = 49). Patients with a higher level of anti-αGal antibodies and NLR values demonstrated a significantly worse survival (P = 0.009, HR = 2.98, n = 48).
  
  
  CONCLUSIONS
  The preoperative levels of anti-TF, -Tn and -αGal antibodies and their dynamics are of prognostic significance. The method for the determination of circulating anti-carbohydrate antibodies may be a useful supplement in clinical outcome assessment.
authors.affiliation: 1. Department of Oncology & Immunology, National Institute for Health Development, Tallinn 11619, Estonia.
authors.forename: Eugeniy
authors.initials: E
authors.lastname: Smorodin
authors.forename: Boris
authors.initials: B
authors.lastname: Sergeyev
authors.forename: Kersti
authors.initials: K
authors.lastname: Klaamas
authors.forename: Valentin
authors.initials: V
authors.lastname: Chuzmarov
authors.forename: Oleg
authors.initials: O
authors.lastname: Kurtenkov
mesh_terms: D000368:Aged; D000888:Antibodies, Anti-Idiotypic / Q000097:blood / Q000276:immunology; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood*; D015179:Colorectal Neoplasms / Q000097:blood* / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000097:blood* / Q000276:immunology; D014312:Trisaccharides / Q000097:blood / Q000276:immunology*
chemical_list: D000888:Antibodies, Anti-Idiotypic; D015295:Antigens, Tumor-Associated, Carbohydrate; D007074:Immunoglobulin G; C040286:Tn antigen; D014312:Trisaccharides; C076569:alpha-galactosyl epitope; C016467:Thomsen-Friedenreich antigen
keywords: Thomsen-Friedenreich; Tn; alpha-Gal; antibodies; enteric microbiota.; gastrointestinal cancer; survival