Ytting Henriette, Christensen Ib Jarle, Thiel Steffen, Jensenius Jens Christian, Nielsen Hans Jørgen
Department of Surgical Gastroenterology, Hvidovre University Hospital, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
Hum Immunol. 2008 Jul;69(7):414-20. doi: 10.1016/j.humimm.2008.05.005. Epub 2008 Jun 11.
Mannan-binding lectin-associated serine protease-2 (MASP-2) is the initiating enzyme of the lectin pathway of complement activation. High preoperative serum levels of MASP-2 are associated with recurrence and poor survival in patients with colorectal cancer (CRC). In this study we investigate the prognostic role of MASP-2 in patients curatively resected for primary CRC. Serum concentrations of MASP-2 were determined in 281 patients prior to surgery and 7 months postoperatively using a time-resolved immunofluorometric assay. End points were recurrent cancer and death within a median follow-up time of 7.9 years. The correlation between pre- and postoperative levels was 0.49. High postoperative levels of MASP-2 were significantly associated with poor survival [p = 0.04; hazard ratio (HR) = 1.35; 95% confidence interval (CI), 1.02-1.80] and recurrence (p = 0.01, HR = 1.6, 95% CI, 1.1-1.6). The inclusion of age, gender, tumor localization, and Dukes stage in multivariate analysis demonstrated that high MASP-2 levels were independently predictive of survival (p = 0.01; HR = 1.5, 95% CI, 1.1-2.0) and recurrence (p = 0.01, HR = 1.6; 95% CI, 1.1-2.4). Combining pre- and postoperative MASP-2 levels did not improve the prediction of survival/recurrence. High postoperative levels of MASP-2 are associated with poor prognosis in patients curatively resected for CRC. A change of the MASP-2 level from preoperative levels was not, per se, predictive of recurrent disease or survival.
甘露聚糖结合凝集素相关丝氨酸蛋白酶2（MASP-2）是补体激活凝集素途径的起始酶。术前血清MASP-2水平升高与结直肠癌（CRC）患者的复发及不良生存相关。在本研究中，我们调查了MASP-2在接受原发性CRC根治性切除患者中的预后作用。采用时间分辨免疫荧光分析法测定了281例患者术前及术后7个月时的血清MASP-2浓度。终点指标为在中位随访时间7.9年内的癌症复发和死亡情况。术前和术后水平的相关性为0.49。术后MASP-2水平升高与不良生存显著相关[p = 0.04；风险比（HR）= 1.35；95%置信区间（CI），1.02 - 1.80]及复发相关（p = 0.01，HR = 1.6，95% CI，1.1 - 1.6）。多因素分析纳入年龄、性别、肿瘤定位和Dukes分期后显示，MASP-2水平升高可独立预测生存（p = 0.01；HR = 1.5，95% CI，1.1 - 2.0）和复发（p = 0.01，HR = 1.6；95% CI，1.1 - 2.4）。联合术前和术后MASP-2水平并不能改善对生存/复发的预测。术后MASP-2水平升高与接受CRC根治性切除患者的不良预后相关。MASP-2水平相对于术前水平的变化本身并不能预测疾病复发或生存情况。
