Serum level of sVAP-1 in relation to the severity of inflammation, predictive marker of prognosis in patients scheduled for colorectal surgery

Abstract

Background: VAP-1, like other adhesion molecules, can exist as soluble circulating form (sVAP-1). Elevated serum sVAP-1 levels were observed in both type 1 and type 2 diabetic patients, in subjects with primary biliary cirrhosis and alcoholic liver cirrhosis, while patients with rheumatoid arthritis or inflammatory bowel disease did not exhibit significant alterations in sVAP-1 level when compared to healthy individuals. Only scarce and controversial information is available on the serum sVAP-1 levels in cases of malignant neoplasms. The purpose of our study was to assess the relationship between the level of soluble vascular adhesion protein 1 and the concentration of inflammatory markers, as well as to assess the predictive value of sVAP-1 in patients with colorectal cancer scheduled for surgery. Methods: Kaplan-Meier analysis and log-rank test were performed to assess the correlation between sVAP-1 levels and the clinical outcomes on disease-free survival (DFS). Results: Compared to healthy individuals, patients suffering from colorectal cancer, expressed a significantly lower levels of sVAP-1 (p < 0.000002) and significantly higher concentrations of CEA (p = 0.003), IL-6 (p = 0.0001), CRP (p = 0.0001), AAG (p = 0.0001), and haptoglobin (p = 0.0001) in the serum. In the studied group of patients, a significant negative correlation between the serum levels of sVAP-1 vs. CRP (r = – 0.195; p = 0.031), sVAP-1 vs. AAG (r = – 0.234; p = 0.009), sVAP-1 vs. HAP (r = – 0.226; p = 0.012) were found. 3-year DFS of the patients with pretreatment levels of CEA ≥ 5 μg/L was significantly lower than the patients with pretreatment levels of CEA < 5 μg/L (47.4% vs. 82.9%, p = 0.00005). 3-year DFS of patients with pretreatment concentrations of sVAP-1≤ 185 μg/L was significantly lower than the patients with pretreatment concentrations of sVAP-1 > 185 μg/L (59.4% vs. 77.4%, p = 0.0378). Conclusions: In patients scheduled for colorectal cancer surgery, serum concentrations of sVAP-1 are related to the tumour stage and the severity of acute phase reaction. Increased CEA concentrations or decreased sVAP-1 levels before surgery is associated with shorter time to disease progression following resection of colorectal cancer.