Preoperative Chitinase 3-like-1, Galectin-3, and Activin Aplasma levels: A novel diagnostic panel for colorectal cancer.

Abstract

546 Background: Colorectal cancers (CRC) expressChitinase 3-Like-1(Chi3L1), Galectin-3 (Gal-3) and Activin A (Act-A). Chi3L1, indirectly, via IL8 and MCP-1, promotes tumor angiogenesis and progression. Gal-3 promotes tumor cell invasion and angiogenesis while Act-A supports cancer cell migration. This study’s goal was to assess the diagnostic value of plasma levels of Chi3L1, Gal-3 and Act-A, alone or together, for CRC. Methods: PreOp plasma samples were obtained from consenting CRC and benign pathology (BP) patients (pts) undergoing elective resection (IRB approved tissue bank). Plasma levels of Chi3L1, Gal-3 (ng/ml), and Act-A (pg/ml) were determined via ELISA and reported as median + 95% CI. The receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were used to evaluate the CRC diagnostic value of single and multiple plasma protein levels. The Mann-Whitney test was used for statistical analysis (significance p<0.05). Results: A total of 118 CRC (81% colon, 19% rectal) and 42 BP pts (adenoma 31%, diverticulitis 53%, other 16%) were studied. The CRC median plasma protein levels were significantly higher vs. the BP group results [Chi3L1: 120.1, CI: 95.0, 146.6 vs. 36.8, CI; 29.3, 44.4; Gal-3: 12.0, CI: 10.5, 13.3 vs. 7.7, CI: 7.2, 9.9; Act-A: 368.0 CI: 341.0, 421.6 vs. 272.1, CI: 196.0, 327.3 [p<0.001 for all]). The AUC value for the ROC curve for Chi3L1, Gal-3 and Act-A were 0.850, 0.724 and 0.734 respectively with 76%, 52% and 38% specificity. The AUC for the combination of these 3 proteins was 0.890 with 88% specificity. Conclusions: Themedian Chi3L1, Gal-3 and Act-1 values in CRC pts were significantly higher (226%, 55% and 35%) then BP levels. The 3 protein combination had improved AUC and specificity vs single protein results and may have value as a diagnostic panel. A larger study is needed.