Abstract
BackgroundAs a secreted protein, serum trefoil factor 3 (TFF3) has been reported to be a biomarker of several malignancies. We further investigated whether TFF3 can be applied as a biomarker for and predictor of responses to chemotherapy in gastrointestinal cancer.MethodsSerum and urine samples were collected from 90 patients with gastric cancer, 128 patients with colorectal cancer and 91 healthy individuals. Serum and urine TFF3 levels were measured using an ELISA.ResultsSerum and urine TFF3 levels were significantly higher in the patients with gastric and colorectal cancer compared with the healthy individuals (P < 0.05). Higher serum levels of TFF3 were significantly correlated with distant metastasis and an advanced stage in the two types of cancer (P < 0.05). Age and the number of lymph node metastases were significantly correlated with serum TFF3 levels in colorectal cancer, and decreased serum TFF3 levels were significantly correlated with responses to chemotherapy in both the gastric and the colorectal cancer partial response (PR) groups. A combination of serum and urine data did not significantly improve the detection of either cancer, although urine levels have shown a significant negative relationship with the glomerular filtration rate (GFR).ConclusionsOur data indicate that TFF3 may be an effective biomarker of tumor stage and the presence of distant metastasis, and may be a pharmacodynamic marker of response to chemotherapy in gastrointestinal cancer.
Highlights
As a secreted protein, serum trefoil factor 3 (TFF3) has been reported to be a biomarker of several malignancies
Receiver operating characteristic (ROC) curve analysis showed that serum TFF3 had 80.0% of positive predictive value, 80% sensitivity and 72.4% specificity, with an area under the ROC curve (AUC) of 0.844 and optimal cut-off (8.98 ng/ml) when gastric cancer patients were separated from healthy individuals
ROC curve analysis showed that urine TFF3 had 73.91% of positive predictive value, 80.4% sensitivity and 80.1% specificity, with an AUC of 0.874 and optimal cut-off (3.12 ng/ml) when gastric cancer patients were separated from healthy individuals
Summary
Serum trefoil factor 3 (TFF3) has been reported to be a biomarker of several malignancies. We further investigated whether TFF3 can be applied as a biomarker for and predictor of responses to chemotherapy in gastrointestinal cancer. Gastric cancer is the fourth most common cancer worldwide and has the third highest mortality rate, accounting for 11% of cancer-related deaths [1]. Colorectal cancer is the third most common cancer globally, accounting for 7.6% of cancer-related deaths worldwide [2]. Cancer outcome is highly dependent on the stage at which the disease is detected. Clinical symptoms mostly arise at a late stage, when the disease has already spread outside of the gastric and colorectal region [3]. Chemotherapy plays an important role for those patients
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