Center for Clinical Pharmacology, University Clinical Hospital Mostar , Mostar , Bosnia and Herzegovina.
Laboratory for Molecular Immunology, University of Zagreb School of Medicine , Zagreb , Croatia.
Nutr Cancer. 2019;71(7):1078-1085. doi: 10.1080/01635581.2019.1597135. Epub 2019 Apr 4.
25-Hydroxyvitamin D (25-OHD) may have a prognostic value in colorectal cancer (CRC) patients. However, as 25-OHD concentration is strongly impacted by surgery, it is uncertain what is the most reliable time-point for 25-OHD assessment, pre- or post-operative. Therefore, we examined 515 CRC patients (AJCC I-III) who underwent surgery. Blood samples were collected either pre-operatively ( = 286; median = 1 day before surgery) or post-operatively ( = 229; median = 8 days). Serum 25-OHD concentration was determined by liquid chromatography-tandem mass spectrometry. Association between 25-OHD and survival was tested in the whole cohort, followed by stratified analyses in pre- and post-operatively sampled. Median 25-OHD in the cohort was 36.7 nmol/L and median follow-up time was 5.9 years. There were no differences between pre- and post-operative cohort in age, sex, 25-OHD, AJCC stage, or localization of tumor. After adjustment, higher 25-OHD (>50 nmol/L) was associated with better overall survival only in post-operative (HR = 0.53; 95% CI: 0.33-0.84; = 0.006), but not in pre-operative cohort (HR = 1.13; 95% CI: 0.77-1.65; = 0.53). In conclusion, higher post-operative 25-OHD levels were associated with better survival outcome in CRC patients, while no such association was found for pre-operative levels. Time-point of blood collection should be addressed carefully in future research as it might affect the prognostic value of 25-OHD in CRC.
25-羟维生素 D（25-OHD）可能对结直肠癌（CRC）患者具有预后价值。然而，由于 25-OHD 浓度受到手术的强烈影响，因此不确定评估 25-OHD 的最可靠时间点是术前还是术后。因此，我们检查了 515 例接受手术的 CRC 患者（AJCC I-III）。采集血样分别在术前（ = 286；中位数=手术前 1 天）或术后（ = 229；中位数=术后 8 天）进行。采用液相色谱-串联质谱法测定血清 25-OHD 浓度。在整个队列中检验 25-OHD 与生存之间的关联，然后在术前和术后采样的队列中进行分层分析。队列的中位 25-OHD 为 36.7 nmol/L，中位随访时间为 5.9 年。术前和术后队列在年龄、性别、25-OHD、AJCC 分期或肿瘤定位方面无差异。调整后，仅在术后（HR=0.53；95%CI：0.33-0.84； = 0.006），而非术前（HR=1.13；95%CI：0.77-1.65； = 0.53），较高的 25-OHD（>50 nmol/L）与更好的总生存相关。总之，较高的术后 25-OHD 水平与 CRC 患者的生存结果相关，而术前水平则无此关联。在未来的研究中，应仔细考虑采血时间点，因为它可能会影响 CRC 中 25-OHD 的预后价值。
