Kinoshita Jun, Fushida Sachio, Harada Shinichi, Makino Isamu, Nakamura Keishi, Oyama Katsunobu, Fujita Hideto, Ninomiya Itasu, Fujimura Takashi, Kayahara Masato, Ohta Tetsuo
Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan.
Oncol Lett. 2010 Nov;1(6):989-994. doi: 10.3892/ol.2010.181. Epub 2010 Sep 23.
Type III procollagen (amino-terminal propeptide of procollagen type III) and type IV collagen are considered to be reliable serum markers for monitoring the progression of liver fibrosis. The peritoneal dissemination of gastric cancer is also characterised by abundant collagen deposition in the peritoneum. The present study was performed to investigate the potential of serum type III procollagen and IV collagen as biomarkers for peritoneal dissemination in gastric cancer. The study population consisted of 117 patients with gastric cancer: 32 patients had peritoneal dissemination which was pathologically diagnosed by laparotomy or laparoscopic examination, while 85 patients (45/40, early/advanced gastric cancer) had no peritoneal dissemination. We measured the serum levels of type III procollagen and type IV collagen in comparison to the commonly accepted tumor markers carcinoembryonic (CEA), carbohydrate antigen (CA)19-9 and CA125. The median type III procollagen levels showed no significant differences between the two groups, whereas the median type IV collagen levels were significantly (201 ng/ml) higher in patients with than in those without peritoneal dissemination (early/advanced gastric cancer, 124/136 ng/ml) (P<0.05). In receiver operating characteristic (ROC) curve analysis, type IV collagen had the largest area under the curve (0.83), followed by CA125 (0.72), CA19-9 (0.64), CEA (0.59) and type III procollagen (0.48). Type IV collagen was an independent marker (P<0.0001, odds ratio 15.7) for predicting peritoneal dissemination along with CA125 (P=0.0086, odds ratio 9.4) based on multivariate logistic regression. In conclusion, serum type IV collagen levels may be significant in the early detection and management of patients with peritoneal dissemination of gastric cancer.
III型前胶原（III型前胶原氨基端前肽）和IV型胶原被认为是监测肝纤维化进展的可靠血清标志物。胃癌的腹膜播散也以腹膜中大量胶原沉积为特征。本研究旨在探讨血清III型前胶原和IV型胶原作为胃癌腹膜播散生物标志物的潜力。研究人群包括117例胃癌患者：32例有腹膜播散，经剖腹手术或腹腔镜检查病理诊断，而85例患者（45/40，早期/晚期胃癌）无腹膜播散。我们测量了III型前胶原和IV型胶原的血清水平，并与公认的肿瘤标志物癌胚抗原（CEA）、糖类抗原（CA）19-9和CA125进行比较。两组间III型前胶原水平中位数无显著差异，而有腹膜播散患者的IV型胶原水平中位数（201 ng/ml）显著高于无腹膜播散患者（早期/晚期胃癌，124/136 ng/ml）（P<0.05）。在受试者工作特征（ROC）曲线分析中，IV型胶原曲线下面积最大（0.83），其次是CA125（0.72）、CA19-9（0.64）、CEA（0.59）和III型前胶原（0.48）。基于多因素逻辑回归分析，IV型胶原是预测腹膜播散的独立标志物（P<0.0001，比值比15.7），CA125也是（P=0.0086，比值比9.4）。总之，血清IV型胶原水平可能对胃癌腹膜播散患者的早期检测和管理具有重要意义。
