Published online Feb 21, 2017. doi: 10.3748/wjg.v23.i7.1233
Peer-review started: November 1, 2016
First decision: December 2, 2016
Revised: December 13, 2016
Accepted: January 3, 2017
Article in press: January 3, 2017
Published online: February 21, 2017
Processing time: 111 Days and 19.9 Hours
To develop predictive markers in blood for colorectal cancer liver metastasis.
Twenty colorectal cancer patients were selected and divided into two groups. Group A consisted of 10 patients whose pathological TNM stage was IIIC (T3-4N2M0), while another 10 patients with synchronous liver metastasis (TNM stage IV) were recruited for group B. During the surgical procedure, a 10-mL drainage vein (DV) blood sample was obtained from the DV of the tumor-bearing segment prior to the ligation of the DV. At the same time, a 10-mL peripheral vein (PV) blood sample was collected via peripheral venipuncture. The serum levels of 24 molecules that are potentially involved in the mechanism of liver metastasis in both DV blood and PV blood were analyzed by using high-throughput enzyme-linked immunosorbent assay technology.
Univariate analysis revealed that platelet-derived growth factor AA (PDGFAA) in DV blood (dPDGFAA) (P = 0.001), PDGFAA in PV blood (pPDGFAA) (P = 0.007), and human epidermal growth factor receptor-2 in PV blood (pHER2) (P = 0.001), pMMP7 (P = 0.028), pRANTES (P = 0.013), and pEGF (P = 0.007) were significantly correlated with synchronous liver metastasis. Multivariate analysis identified dPDGFAA (HR = 1.001, P = 0.033) and pHER2 (HR = 1.003, P = 0.019) as independent predictive factors for synchronous liver metastasis. Besides, high peripheral HER2 level may also be a risk factor for metachronous liver metastasis, although the difference did not reach statistical significance (P = 0.06). Significant correlations were found between paired DV and PV blood levels for PDGFAA (r = 0.794, P < 0.001), but not for HER2 (r = 0.189, P = 0.424).
PDGFAA in tumor drainage and HER2 in PV blood may be useful predictive factors for synchronous liver metastasis of colorectal cancer.
Core tip: We investigated the serum levels of most commonly studied tumor growth factors that are known to be associated with the mechanism of liver metastasis not only in peripheral vein (PV) blood but also in tumor drainage vein (DV) blood. To our knowledge, this is one of few studies taking DV blood into analysis and comparing the differences in serum molecules between PV blood and DV blood. We found that platelet-derived growth factor AA in tumor drainage and human epidermal growth factor receptor 2 in PV blood may be useful predictive factors for synchronous liver metastasis of colorectal cancer.