Pre- and post-operative plasma big endothelin-1 levels in patients with gastric carcinoma undergoing radical gastrectomy.

BACKGROUND

Big Endothelin-1 levels increase significantly in patients with various tumors, and raised plasma concentrations are associated with worse outcome. The aim of this study was to investigate plasma Big Endothelin-1 levels in patients with gastric carcinoma before and after radical gastrectomy and to explore its clinical significance.

MATERIALS AND METHODS

One hundred and six patients with gastric carcinoma and 20 controls were studied. Big Endothelin-1 plasma levels in patients with advanced gastric cancer were examined by enzyme-linked immunosorbent assay before and on days 1, 3 and 10 after curative surgery and were then tested every 3 months.

RESULTS

All patients, except those with stage I gastric cancer, had significantly higher mean plasma Big Endothelin-1 levels compared with the normal controls (p = 0.000). The plasma Big Endothelin-1 levels were markedly increased on the first post-operative day (1st POD) in all patients but decreased on the 3rd POD with no significant difference compared to the pre-operative levels. On the 10th POD, patients with stages I and II gastric cancer showed a marked reduction in the plasma Big Endothelin-1 levels (p=0.010 and p=0.000, respectively), whereas no significant difference was observed in stage III and IVpatients. During the follow-up, plasma Big Endothelin-1 levels immediately before recurrences occurred in stage II patients were significantly higher compared with the levels on the 10th POD (p=0.011).

CONCLUSION

Plasma Big Endothelin-1 levels might be a reliable marker to determine the severity of gastric carcinoma. Monitoring plasma Big Endothelin-I levels after curative resection in stage II gastric cancer patients was valuable in predicting recurrences.