title: Correlation between serum tryptase, mast cells positive to tryptase and microvascular density in colo-rectal cancer patients: possible biological-clinical significance.
abstract: BACKGROUND
  Tryptase is a serin protease stored and released from mast cells (MCs) that plays a role in tumour angiogenesis. In this study we aimed to evaluate serum tryptase levels in colo-rectal cancer (CRC) patients before (STLBS) and after (STLAS) radical surgical resection. We also evaluated mast cell density positive to tryptase (MCDPT) and microvascular density (MVD) in primary tumour tissue.
  
  
  METHODS
  A series of 61 patients with stage B and C CRC (according to the Astler and Coller staging system) were selected. Serum blood samples were collected from patients one day before and one day after surgery. Tryptase levels were measured using the UniCAP Tryptase Fluoroenzymeimmunoassay (Pharmacia, Uppsala, Sweden). Tumour sections were immunostained with a primary anti-tryptase antibody (clone AA1; Dako, Glostrup, Denmark) and an anti CD-34 antibody (QB-END 10; Bio-Optica Milan, Italy) by means of immunohistochemistry and then evaluated by image analysis methods.
  
  
  RESULTS
  The mean ± s.d. STLBS and STLAS was 5.63±2.61 µg/L, and 3.39±1.47 µg/L respectively and a significant difference between mean levels was found: p = 0.000 by t-test. The mean ± s.d. of MCDPT and MVD was 8.13±3.28 and 29.16±7.39 respectively. A strong correlation between STLBS and MVD (r = 0.83, p = 0.000); STLBS and MCDPT (r = 0.60, p = 0.003); and MCDPT and MVD (r = 0.73; p = 0.001) was found.
  
  
  CONCLUSIONS
  Results demonstrated higher STLBS in CRC patients, indicating an involvement of MC tryptase in CRC angiogenesis. Data also indicated lower STLAS, suggesting the release of tryptase from tumour-infiltrating MCs. Serum tryptase levels may therefore play a role as a novel bio-marker predictive of response to radical surgery. In this context tryptase inhibitors such as Gabexate and Nafamostat Mesilate might be evaluated in adjuvant clinical trials as a new anti-angiogenic approach.
authors.affiliation: Department of Medical and Surgery Science, Clinical Surgery Unit, University of Catanzaro "Magna Graecia" Medical School, Catanzaro, Italy; Surgery Unit, National Cancer Research Centre Istituto Tumori "Giovanni Paolo II", Bari, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Ammendola
authors.affiliation: Department of Medical and Surgery Science, Clinical Surgery Unit, University of Catanzaro "Magna Graecia" Medical School, Catanzaro, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Sacco
authors.affiliation: Department of Medical and Surgery Science, Clinical Surgery Unit, University of Catanzaro "Magna Graecia" Medical School, Catanzaro, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sammarco
authors.affiliation: Department of Medical and Surgery Science, Pathology Unit, University of Catanzaro "Magna Graecia" Medical School, Catanzaro, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Donato
authors.affiliation: Surgery Unit, National Cancer Research Centre Istituto Tumori "Giovanni Paolo II", Bari, Italy.
authors.forename: Severino
authors.initials: S
authors.lastname: Montemurro
authors.affiliation: Surgery Unit, National Cancer Research Centre Istituto Tumori "Giovanni Paolo II", Bari, Italy.
authors.forename: Eustachio
authors.initials: E
authors.lastname: Ruggieri
authors.affiliation: Department of Health, ASL BAT, Bari, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Patruno
authors.affiliation: Interventional Radiology Unit with Integrated Section of Translational Medical Oncology, National Cancer Research Centre Istituto Tumori "Giovanni Paolo II", Bari, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Marech
authors.affiliation: Interventional Radiology Unit with Integrated Section of Translational Medical Oncology, National Cancer Research Centre Istituto Tumori "Giovanni Paolo II", Bari, Italy.
authors.forename: Marica
authors.initials: M
authors.lastname: Cariello
authors.affiliation: Department of Biomedical Science and Human Oncology Clinica Medica "G. Baccelli", University of Bari Medical School, Bari, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Vacca
authors.affiliation: Interventional Radiology Unit with Integrated Section of Translational Medical Oncology, National Cancer Research Centre Istituto Tumori "Giovanni Paolo II", Bari, Italy.
authors.forename: Cosmo Damiano
authors.initials: CD
authors.lastname: Gadaleta
authors.affiliation: Interventional Radiology Unit with Integrated Section of Translational Medical Oncology, National Cancer Research Centre Istituto Tumori "Giovanni Paolo II", Bari, Italy.
authors.forename: Girolamo
authors.initials: G
authors.lastname: Ranieri
mesh_terms: D015179:Colorectal Neoplasms / Q000097:blood* / Q000098:blood supply / Q000201:enzymology* / Q000601:surgery; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008407:Mast Cells / Q000201:enzymology* / Q000473:pathology; D055806:Microvessels / Q000473:pathology*; D053802:Tryptases / Q000097:blood*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D042461:Vascular Endothelial Growth Factor A; D053802:Tryptases