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Nagel M, Schulz J, Maderer A, Goepfert K, Gehrke N, Thomaidis T, Thuss-Patience PC, Al-Batran SE, Hegewisch-Becker S, Grimminger P, Galle PR, Möhler M, Schattenberg JM. Cytokeratin-18 fragments predict treatment response and overall survival in gastric cancer in a randomized controlled trial. Tumour Biol 2018. [PMID: 29534639 DOI: 10.1177/1010428318764007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Gastric cancer is common malignancy and exhibits a poor prognosis. At the time of diagnosis, the majority of patients present with metastatic disease which precludes curative treatment. Non-invasive biomarkers which discriminate early from advanced stages or predict the response to treatment are urgently required. This study explored the cytokeratin-18 fragment M30 and full-length cytokeratin-18 M65 in predicting treatment response and survival in a randomized, placebo-controlled trial of advanced gastric cancer. METHODS Patients enrolled in the SUN-CASE study received sunitinib or placebo as an adjunct to standard therapy with leucovorin (Ca-folinate), 5-fluorouracil, and irinotecan in second or third line. Treatment response rates, progression-free survival and overall survival were assessed during a follow-up period of 12 months. Cytokeratin-18 fragments were analyzed in 52 patients at baseline and day 14 of therapy. RESULTS Levels of M30 correlated with the presence of metastasis and lymph node involvement and decreased significantly during chemotherapy. Importantly, baseline levels of M30 were significantly higher in patients who failed therapy. In addition, patients who did not respond to treatment were also identifiable at day 14 based on elevated M30 levels. By stepwise regression analysis, M30 at day 14 was identified as independent predictor of treatment response. Likewise, serum levels of full-length cytokeratin-18 M65 at baseline also correlated with treatment failure and progression-free survival. The addition of sunitinib did not exert any effects on serum levels of M30 or M65. CONCLUSION The cytokeratin-18 fragment M30 at day 14 identifies patients that fail to second- or third-line therapy for advanced gastric cancer. Validation of this non-invasive biomarker in gastric cancer is warranted.
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Affiliation(s)
- Michael Nagel
- 1 Department of Medicine I, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Julia Schulz
- 1 Department of Medicine I, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Annett Maderer
- 1 Department of Medicine I, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Katrin Goepfert
- 1 Department of Medicine I, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Nadine Gehrke
- 1 Department of Medicine I, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Thomaidis
- 1 Department of Medicine I, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Peter C Thuss-Patience
- 2 Department of Hematology, Oncology and Tumor Immunology, Campus Virchow-Klinikum, Charite-University Medicine Berlin, Berlin, Germany
| | - Salah E Al-Batran
- 3 Institute of Clinical Cancer Research, Krankenhaus Nordwest, UCT University Cancer Center, Frankfurt am Main, Germany
| | | | - Peter Grimminger
- 5 General-, Visceral- and Transplant Surgery; University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Peter Robert Galle
- 1 Department of Medicine I, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Markus Möhler
- 1 Department of Medicine I, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jörn Markus Schattenberg
- 1 Department of Medicine I, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
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Song HF, Xu P. New serological markers for liver damage. Shijie Huaren Xiaohua Zazhi 2017; 25:2681-2688. [DOI: 10.11569/wcjd.v25.i30.2681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The liver is the most important detoxification organ in the human body, and the damage to the liver will seriously affect the health of the body. Alanine transaminase (ALT) and aspartate transaminase (AST) are the most widely used clinical biochemical markers for liver injury. However, elevated serum ALT and AST levels can also occur in other diseases, which reduces their diagnostic value in liver injury. In order to diagnose liver damage more accurately, we need to find serum markers for liver injury.
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Affiliation(s)
- Hua-Feng Song
- Central Laboratory, the Fifth People's Hospital of Suzhou, Suzhou 215007, Jiangsu Province, China
| | - Ping Xu
- Central Laboratory, the Fifth People's Hospital of Suzhou, Suzhou 215007, Jiangsu Province, China,Suzhou Key Laboratory of Tuberculosis Prevention and Control, Suzhou 215007, Jiangsu Province, China
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Malek-Hosseini Z, Khezri A, Amirghofran Z. Circulating Levels of M30 and M65 Molecules in Transitional Cell Carcinoma of the Bladder and Their Relation to Tumor Progression. IRANIAN JOURNAL OF CANCER PREVENTION 2016; 9:e4086. [PMID: 27482329 PMCID: PMC4951759 DOI: 10.17795/ijcp-4086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 03/14/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Various markers are suggested for diagnosis and monitoring of transitional cell carcinoma of the bladder (TCC), including cytokeratins (CKs). OBJECTIVES In the present study, the circulating CK18 (M65) and its caspase-cleaved form, ccCK18 (M30), have been investigated in a group of patients with TCC. PATIENTS AND METHODS Serum samples were obtained from 60 patients before surgical resection, among which the samples of 26 patients after resection were also included. We measured the levels of soluble M30 and M65 molecules by enzyme-linked immunosorbent assay. The relation between these markers and patients' clinical characteristics was evaluated. RESULTS M30 and M65 in total patient sera were 148 ± 16 U/L and 318 ± 34 U/L, respectively. A correlation existed between pre-operative M30 and M65 levels (P < 0.0001, Spearman r = 0.51). M65, but not M30, showed a significant relation to tumor stage and grade. The M65 quantity in patients with T3/T4 tumor stages (350 ± 42 U/L) was higher than that of patients with T1/T2 stages (293 ± 45U/L; P < 0.038). Patients with tumor grades III/IV also showed higher levels of M65 compared to patients with tumor grades I/II (P < 0.04). The M30:M65 ratio in all patients was 0.54 ± 0.04. There was a lower M30:M65 ratio in patients with T3/T4 stage tumors and those with tumor grades III/IV (P < 0.02). The M30 (133 ± 19 U/L) and M65 levels (240 ± 21 U/L) after surgery did not significantly differ compared to their pre-operative values. However, a correlation between the pre- and post-operative M30:M65 ratio in patients ≥ 70 years was seen (P = 0.009). CONCLUSIONS These data suggested a relationship of both M65 and the M30:M65 ratio to tumor progression which might imply their importance in TCC monitoring.
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Affiliation(s)
- Zahra Malek-Hosseini
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Abdolaziz Khezri
- Department of Urology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Zahra Amirghofran
- Department of Immunology, Autoimmune Disease Research Center, Medicinal and Natural Products Chemistry Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
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Incebiyik A, Camuzcuoglu H, Vural M, Hilali NG, Camuzcuoglu A, Seker A, Taskin A, Aksoy N. Assessment of Apoptotic Activity Dysregulation and Oxidative Stress in the Development of Epithelial Ovarian Cancer: A Case-Controlled Descriptive Analysis. Gynecol Obstet Invest 2015; 81:71-7. [DOI: 10.1159/000381774] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 03/18/2015] [Indexed: 11/19/2022]
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Can circulating M30 and M65 levels be beneficial markers in the diagnosis and management of patients with complete hydatidiform mole? Wien Klin Wochenschr 2015; 128:566-571. [PMID: 25869758 DOI: 10.1007/s00508-015-0735-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 01/19/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The objective of this study is to evaluate the prognostic value of M30 and M65 levels as markers of apoptotic activity and maternal serum oxidative stress in patients with complete hydatidiform mole (CHM). METHODS In total, 68 pregnant women were included in the study. The study group included 34 pregnant with CHM, while 34 healthy pregnant were employed as a control group. Venous blood samples were drawn to assess the maternal serum oxidative stress and M30-M65 levels. In addition, a second blood sample was drawn from patients with CHM on day 8 after dilatation evacuation. RESULTS Maternal serum oxidative stress and M30-M65 levels were found to be significantly higher in patients with CHM as compared with the control group. It was found that serum β-subunit of human chorionic gonadotropin (β-hCG) level had a significant positive correlation with M30-M65 levels in patients with CHM. In addition, serum M65 level was found to be as effective as β-hCG in the identification of the patients with CHM. CONCLUSION Our results indicated that oxidative stress and apoptosis may play significant roles in CHM development. In addition, it seems that serum M30-M65 levels can presumably be an ancillary laboratory test to β-hCG in the diagnosis and follow-up of the patients with CHM.
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Cevatemre B, Ulukaya E, Sarimahmut M, Oral AY, Frame FM. The M30 assay does not detect apoptosis in epithelial-derived cancer cells expressing low levels of cytokeratin 18. Tumour Biol 2015; 36:6857-65. [DOI: 10.1007/s13277-015-3367-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 03/24/2015] [Indexed: 12/18/2022] Open
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Sinthujaroen P, Wanachottrakul N, Pinkaew D, Petersen JR, Phongdara A, Sheffield-Moore M, Fujise K. Elevation of serum fortilin levels is specific for apoptosis and signifies cell death in vivo. BBA CLINICAL 2014; 2:103-111. [PMID: 25558447 PMCID: PMC4280861 DOI: 10.1016/j.bbacli.2014.10.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Billions of cells undergo apoptosis each day in the average normal adult. The ability to readily assess the degree of apoptosis in human diseases is hampered by the lack of sensitive and specific serum biomarkers of apoptosis. Fortilin is a novel prosurvival molecule that protects cells against various noxious stimuli. While fortilin is secreted into the extracellular space under certain conditions, the relationship between the serum concentration of fortilin and the presence and extent of apoptosis in vivo remains unknown. Methods & results Using a newly developed fortilin ELISA system, we show here that fortilin exists in the normal human and mouse circulation. We further demonstrate that fortilin serum levels are significantly elevated in patients with solid cancer, in response to anti-cancer chemo- or radiation therapy. The elevation of fortilin serum levels is more robust and sensitive than that of such previously-reported serum biomarkers of apoptosis as fragmented cytokeratin-18, cytochrome c, and nucleosomal DNA. In addition, targeted apoptotic liver damage induced by Jo2 anti-Fas (CD95) antibody consistently and significantly increased serum fortilin levels in C57BL/6J mice. Finally, when challenged by anti-human-Fas IgM antibody, Jurkat leukemic T cells apoptosed and released fortilin into the medium before plasma membrane integrity was compromised. Conclusions Taken together, these data suggest that serum fortilin levels reflect the degree and extent of apoptosis occurring in vivo. General significance Fortilin is a viable serum biomarker of in vivo apoptosis and can be utilized to noninvasively assess the status of in vivo apoptosis in humans. Ultra-sensitive fortilin ELISA has been developed. Fortilin circulates in blood. Fortilin serum levels become highly elevated after apoptosis-inducing therapy. Fortilin is more robust and sensitive than other serum apoptosis markers. Fortilin is actively secreted before plasma membrane becomes disrupted. Fortilin is an excellent serum biomarker of in vivo apoptosis.
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Affiliation(s)
- Patuma Sinthujaroen
- Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch at Galveston, TX 77555, USA
- Center for Genomics and Bioinformatics Research, Faculty of Science, Prince of Songkla University, Thailand
| | - Nattaporn Wanachottrakul
- Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch at Galveston, TX 77555, USA
| | - Decha Pinkaew
- Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch at Galveston, TX 77555, USA
| | - John R. Petersen
- Department of Pathology, University of Texas Medical Branch at Galveston, TX 77555, USA
| | - Amornrat Phongdara
- Center for Genomics and Bioinformatics Research, Faculty of Science, Prince of Songkla University, Thailand
| | - Melinda Sheffield-Moore
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Texas Medical Branch at Galveston, TX 77555, USA
| | - Ken Fujise
- Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch at Galveston, TX 77555, USA
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch at Galveston, TX 77555, USA
- Corresponding author at: Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, 301 University Blvd, Suite JSA5.106G, Galveston, TX 77555, USA. Tel.: + 1 409 772 4885; fax: + 1 409 419 1777.
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Tas F, Karabulut S, Yildiz I, Duranyildiz D. Clinical significance of serum M30 and M65 levels in patients with breast cancer. Biomed Pharmacother 2014; 68:1135-40. [PMID: 25465151 DOI: 10.1016/j.biopha.2014.10.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 10/18/2014] [Indexed: 12/24/2022] Open
Abstract
M30 and M65 are relatively new assays that detect different circulating forms of the epithelial cell structural protein cytokeratin18. The objective of this study was to determine the clinical significance of the serum levels of M30 and M65 in patients with breast cancer. A total of 80 patients with a pathologically confirmed diagnosis of breast cancer were enrolled into the study. Serum M30 and M65 concentrations were determined by the solid-phase sandwich ELISA method. Serum samples were obtained on first admission before any type of treatment. The median age at diagnosis was 52 years, range 30 to 81 years. The baseline serum M30 and M65 levels in patients with metastatic disease were significantly higher than those in the non-metastatic patients (P=0.017 and P=0.003, respectively). Moreover, serum M65 level was also elevated in patients with large tumor size (P=0.02). No correlation was found between these serum assay levels and response to chemotherapy (P>0.05). However, the significant relationship was found between the serum levels of M30 and M65 (rs=0.96, P<0.001). Neither serum M30 nor serum M65 had significantly effect on survival (P=0.50, and P=0.52, respectively). In conclusion, although both serum M30 and M65 levels are elevated in metastatic disease, no predictive and prognostic roles on survival were found in patients with breast cancer.
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Affiliation(s)
- Faruk Tas
- Institute of Oncology, University of Istanbul, Istanbul, Turkey.
| | - Senem Karabulut
- Institute of Oncology, University of Istanbul, Istanbul, Turkey
| | - Ibrahim Yildiz
- Institute of Oncology, University of Istanbul, Istanbul, Turkey
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A high serum level of M65 is associated with tumour aggressiveness and an unfavourable prognosis for epithelial ovarian cancer. Cancer Chemother Pharmacol 2013; 72:437-44. [PMID: 23801282 DOI: 10.1007/s00280-013-2212-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 06/10/2013] [Indexed: 12/20/2022]
Abstract
PURPOSE This study was conducted to determine the clinical significance of serum M30 and M65 in epithelial ovarian cancer (EOC). METHODS A total of 56 patients with EOC and 56 healthy women were included in the study. All of the patients received platinum-based chemotherapy. Pretreatment levels of M30 and M65 were measured using the quantitative ELISA method. RESULTS The median M30 and M65 serum levels were significantly elevated in the EOC patients compared with the healthy controls (96.7 vs. 69.5, p = 0.028 and 436.4 versus 166.3, p < 0.001, respectively). The cut-off value of 423.4 U/L for M65 determined with ROC analysis, predicted progression with 75.1 % sensitivity and 65.6 % specificity (AUC = 0.708, p = 0.008). Patients with higher M65 levels had shorter progression-free survival (PFS) (p = 0.021). Both M30 and M65 serum levels were significantly higher for serous-type histology (p = 0.001 and p < 0.001, respectively). Increased M65 serum levels were associated with advanced disease (p = 0.005) and higher grade (p = 0.005). Moreover, M65 levels were higher for chemotherapy-resistant patients (p = 0.04). Multivariate analysis revealed that an elevated serum M65 level was the only significant independent prognostic factor (p = 0.039, HR 3.792). CONCLUSIONS These results indicated that serum M30 and M65 levels were significantly elevated in patients with EOC compared with healthy women. Particularly, high serum M65 levels were associated with poor prognosis and resistance to platinum-based chemotherapy.
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Clinical significance of serum M30 and M65 levels in metastatic pancreatic adenocarcinoma. Tumour Biol 2013; 34:3529-36. [PMID: 23784459 DOI: 10.1007/s13277-013-0931-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 06/12/2013] [Indexed: 12/29/2022] Open
Abstract
M30 and M65 are relatively new assays that detect different circulating forms of the epithelial cell structural protein cytokeratin 18. This study was conducted to investigate the serum levels of M30 and M65 in patients with metastatic pancreatic adenocarcinoma (MPA) and the relationship with tumor progression and known prognostic parameters. Twenty-six patients with MPA were investigated. Serum samples were obtained on first admission before treatment and follow-up. Both serum M30 and M65 levels were determined using enzyme-linked immunosorbent assay. The median age at diagnosis was 59 years, range 32-80 years; 14 patients were men. All patients had metastatic stage, and most (n = 21, 81%) had hepatic metastasis. The baseline levels of both serum M30 and serum M65 were significantly higher in patients with MPA than those in the control group (p < 0.001, for both assays). Serum M65 level was only significantly higher in the patients with elevated serum LDH levels than in others with normal serum LDH levels (p = 0.03). For serum M30 levels, no correlation was found. The significant relationship was found between the serum levels of M30 and M65 (r(s) = 0. 926, n = 26, p < 0.001, Spearman's correlation). The median survival for all patients was 31.7 ± 2.2 weeks (95% CI = 27.31-36.08). Although only the serum LDH level was found to be a significant prognostic factor (p = 0.01), neither serum M30 nor serum M65 had significant effect on survival (p = 0.28 and p = 0.15, respectively). In conclusion, although both serum levels of M30 and M65 assays were found to be of diagnostic value, no predictive and prognostic values were determined in MPA patients.
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