Abstract
The role of oxidative stress (OS) in cancer is a matter of great interest due to the implication of reactive oxygen species (ROS) and their oxidation products in the initiation of tumorigenesis, its progression, and metastatic dissemination. Great efforts have been made to identify the mechanisms of ROS-induced carcinogenesis; however, the validation of OS byproducts as potential tumor markers (TMs) remains to be established. This interventional study included a total of 80 colorectal cancer (CRC) patients and 60 controls. By measuring reduced glutathione (GSH), its oxidized form (GSSG), and the glutathione redox state in terms of the GSSG/GSH ratio in the serum of CRC patients, we identified significant changes as compared to healthy subjects. These findings are compatible with the effectiveness of glutathione as a TM. The thiol redox state showed a significant increase towards oxidation in the CRC group and correlated significantly with both the tumor state and the clinical evolution. The sensitivity and specificity of serum glutathione levels are far above those of the classical TMs CEA and CA19.9. We conclude that the GSSG/GSH ratio is a simple assay which could be validated as a novel clinical TM for the diagnosis and monitoring of CRC.
Highlights
The role of oxidative stress (OS) in cancer has been a favored topic for research in the recent years
* p-value adjusted for age and body mass index; n: number of cases; BMI: body mass index; EGF: estimated glomerular filtration; TSI: transferrin saturation index; CRP: C-reactive protein; IL-6: interleukin 6; N/L: neutrophil/lymphocyte index
No significant differences were observed between the two groups in terms of age and sex, but there were in terms of weight and height and in body mass index (BMI)
Summary
The role of oxidative stress (OS) in cancer has been a favored topic for research in the recent years. For the diagnosis and clinical monitoring of CRC, serum tumor markers (TMs) such as carcinoembryonic antigen (CEA) and the carbohydrate antigen recognized by the monoclonal antibody NS19.9 (CA 19.9) are currently used. Their clinical usefulness remains controversial from diagnostic, prognostic, and surveillance points of view. There is no compilation of clinical studies evaluating the role of glutathione itself and, at the present time, the information regarding the changes in the tripeptide at the systemic level and its use as a. We gain further insight into the effectiveness of glutathione in terms of its clinical validation and present experimental evidence which allow for the proposal of GSH and the percentage ratio GSSG/GSH as an emergent TM for the diagnosis and monitoring of CRC
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