Cholinesterase estimations revisited: the clinical relevance:

Preoperative serum cholinesterase as a prognostic factor in patients with colorectal cancer

Aim

Serum cholinesterase (ChE) levels are considered to reflect nutritional status. Although ChE has been well documented as a prognostic factor for some cancers, no clear consensus on its use for colorectal cancer (CRC) has been reached. The aim of this study was to investigate the relationship between preoperative serum ChE and postoperative long-term prognosis in CRC patients.

Methods

A total of 1053 CRC patients who underwent curative surgery were included in this study. The correlations between the preoperative ChE value and overall survival (OS) or cancer-specific survival (CSS) were assessed. By dividing patients into two groups according to their ChE value, OS and CSS were compared between the groups.

Results

Multivariate analysis revealed that the continuous ChE value was a significant predictor of OS (hazard ratio, 0.996; 95% CI, 0.993-0.998; p = 0.002) and CSS (hazard ratio, 0.994; 95% CI, 0.991-0.998; p = 0.001), independent of other variables. The low-ChE (≤234 U/L) group had a significantly poorer prognosis than the high-ChE (>234 U/L) group for both OS (5-year OS for low ChE and high ChE: 79.8% and 93.3%, respectively; p < 0.001) and CSS (5-year CSS for low ChE and high ChE: 84.8% and 95.6%, respectively; p < 0.001).

Conclusions

Lower preoperative serum ChE levels are a predictive factor of poor prognosis for CRC patients. As serum ChE levels can be measured quickly and evaluated easily, ChE could become a useful marker for predicting the postoperative long-term outcomes of CRC patients.

Influence of physical exercise and gender on acetylcholinesterase and butyrylcholinesterase activity in human blood samples

The determination of cholinesterase activity in plasma and erythrocytes serves as a useful and sensitive biomarker of exposure to organophosphorus and carbamate pesticides. However, acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activity may be influenced by factors such as age, gender, drugs, and physical exercise. The aim of this study was to evaluate the effects of gender and physical exercise on the activity of AChE and BuChE in healthy individuals. The values for both enzymes were lower for women. Physical exercise increased the levels of BuChE, and had no significant effect on AChE. To our knowledge, this is the first clinical study evaluating the influence of physical exercise in levels of these enzymes. Considering that cholinesterase activity is a useful parameter in assessing the exposure of individuals to pesticides, it is important to understand factors that influence the determination of the enzymes in order to avoid the erroneous interpretation of results.