[Serum haptoglobin and alpha-1 antitrysin levels as biological evolution markers in patients with gastric and colorectal cancer].

Increased serum levels of acute-phase proteins in cancers are considered to be indicative for the presence of a tumour. Following radical treatment, their serum levels are expected to revert to normal. Haptoglobin and alpha-1 antitrypsin have important serum concentrations which allow precision in the detection of their variations. The aim of the study was to determine wherther serial measurements of haptoglobin and alpha-1-antitrypsin levels could be relevant in postoperative monitoring of patients with gastrointestinal cancer. As a model advanced disease was used. Haptoglobin and alpha-1-antitypsin serum levels were determined in 20 healthy controls, andin 100 camples of sera originating from 61 patients with advanced disease: 21 with 16 gastric carcinoma, 27 with 17 large bowel cancer, and 52 with 28 rectal cancer. Both proteins were determined by radial immunodiffusion M+/-SD in healthy controls, being 2.167 +/- 0.733 g/l for HP and 2.372 +/- 0.481 g/l for alpha-1-antitrypsin. Haptoglobin M+/-SD was 2.256 +/- 1.466 in gastric carcinoma, 3.031 +/- 1.517 in bowel cancer and 2.964 +/- 1.189 in rectal cancer. The difference from healthy controls was significant in bowel cancer (p < 0.05) and rectal cancer (p < 0.01). It was also significant between gastric carcinoma and rectal cancer (p < 0.05). Alpha-1-antitrypsin M+/-SD was 2.557 +/- 1.063 in gastric carcinoma, 2.885 +/- 1.746 in bowel cancer and 3.111 +/- 1.192 in rectal cancer. The difference from healthy subjects was significant only for rectal cancer (p < 0.01). In 28 patients with serial sera samples, the disease progression was associated in 64-68% of them with further increase of haptoglobin and alpha-1-antitrypsin levels. Development of microangiopathic haemolytic anaemia decreased levels of both haptoglobin (1.444 +/- 1.165 vs 2.833 +/- 1.311 in the whole group, (p < 0.05) and alpha-1-antitrypsin (1.405 +/- 0.859 vs. 2.934 +/- 1.252 in the whole group, (p < 0.01). Serial determination of haptoglobin and alpha-1-antitrypsin levels seem to be useful in postoperative monitoring of patients with rectal cancer and possibly bowel cancer. They are of no relevance in monitoring patients with gastric carcinoma. Microangiopathic haemolytic anaemia development is associated with serum depletion of both haptoglobin and alpha-1-antitrypsin.