Abstract
BackgroundCancer cachexia is a complex wasting syndrome affecting patients with advanced cancer, with systemic inflammation as a key component in pathogenesis. Protein degradation and release of amino acids (AAs) in skeletal muscle are stimulated in cachexia. Here, we define factors contributing to serum AA levels in colorectal cancer (CRC).MethodsSerum levels of nine AAs were characterised in 336 CRC patients and their relationships with 20 markers of systemic inflammatory reaction, clinicopathological features of cancers and patient survival were analysed.ResultsLow serum glutamine and histidine levels and high phenylalanine levels associated with indicators of systemic inflammation, including high modified Glasgow Prognostic Score, high blood neutrophil/lymphocyte ratio and high serum levels of CRP, IL-6 and IL-8. Low levels of serum glutamine, histidine, alanine and high glycine levels also associated with advanced cancer stage and with poor cancer-specific survival in univariate analysis.ConclusionsIn CRC, serum AA levels are associated with systemic inflammation and disease stage. These findings may reflect muscle catabolism induced by systemic inflammation in CRC.
Highlights
Colorectal cancer (CRC) is the third most common cancer worldwide and a major cause of mortality.[1]
We have shown that the levels of several cytokines, including IL-6, are increased in colorectal cancer (CRC) patients,[9] especially in patients with systemic inflammation as determined by the modified Glasgow Prognostic Score,[9] a measure based on the circulating levels of CRP and albumin.[10]
We analysed the factors contributing to serum amino acids (AAs) levels in CRC, focusing on the impact of systemic inflammation on the serum AA profile
Summary
Colorectal cancer (CRC) is the third most common cancer worldwide and a major cause of mortality.[1]. Cancer cachexia is a complex wasting syndrome affecting patients with advanced cancer, with systemic inflammation as a key component in pathogenesis. We define factors contributing to serum AA levels in colorectal cancer (CRC). METHODS: Serum levels of nine AAs were characterised in 336 CRC patients and their relationships with 20 markers of systemic inflammatory reaction, clinicopathological features of cancers and patient survival were analysed. Low levels of serum glutamine, histidine, alanine and high glycine levels associated with advanced cancer stage and with poor cancer-specific survival in univariate analysis. CONCLUSIONS: In CRC, serum AA levels are associated with systemic inflammation and disease stage. These findings may reflect muscle catabolism induced by systemic inflammation in CRC
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