| Objective To study the expression of ZAG in patients with or without gastrointestinal cancer and those with or without cachexia. To analyze the relationship between ZAG and gastrointestinal cancer cachexia. To analyze the correlation of ZAG in different tissues and body fluids, and to infer the principle source of ZAG.Methods From April to October 2009,120 inpatients in the general surgery department of Zhongshan Hospital Affiliated to Fudan University were selected and divided into three groups, including cancer cachexia group(n=40), non-cachexia group(n=40) and control group(n=40).Patients with gastrointestinal cancer were diagnosed for the first time not receiving any preoperative treatments, and confirmed by pathological examination after operations.Patients with cachexia should have lost 5% of their weight in three months, or 10% in six months at least. Four samples, including serum, urine, abdominal subcutaneous fat tissue and tumor tissue, were collected. The contents of ZAG in these samples were quantitatively detected by ELISA respectively. The expressions of ZAG in fat and tumor tissues were detected by Western Blot. SPSS 15.0 was used for statistic analysis.Results There were 67 males and 53 females in the 120 patients who were between the age of 31 and 86, and all of them belong to Han nationality. All cancer cases were pathological diagnosed as adenocarcinoma, including 45 gastric carcinoma,22 colon carcinoma and 13 rectal carcinoma. The control cases were 14 abdominal external hernia patients,22 cholecystolithiasis patients,3 cholecystic polips patients, and 1 splenic cyst patient aswell.The sex proportion and ages in three groups had no statistic differences.The average content of ZAG in serum and urine of patients with gastrointestinal cancer were 152.2μg/ml and 158.3μg/ml, significantly higher than those in benign diseases, which were 27.1μg/ml and 26.1μg/ml,respectively (P<0.001).The patients with cachexia had higher levels of ZAG in serum, urine and tumor tissue than those without, with the P value 0.010,0.022 and 0.005 respectively, while in fat tissue there was no significant difference (P=0.060).The content of ZAG in tumor tissue had a strong correlation with serum and urine with correlation coefficients of 0.735 and 0.676 respectively, while in fat tissue the correlation coefficient were 0.457 and 0.534 respectively. It was thus clear that the content of ZAG in tissues had a positive relationship with body fluids, and it was much stronger in tumor tissue.Western Blot showed that the expression of ZAG in gastrointestinal cancer patients was markedly increased compare to those in control group both in tumor and fat tissue.The expression of ZAG in patients with cachexia was slightly higher than those without cachexia in fat tissue, while in tumor tissue the difference was much more evident. It illustrated that the expression of ZAG in patients with cachexia was obviously up-regulated, and it was more remarkable in tumor than in fat tissue.Conclusion Similar with prostatic and mammary cancer, the expression of ZAG elevated in gastrointestinal cancer patients, and had a further enhancement in patients with cachexia. ZAG expression showed significant relevance with gastrointestinal cancer and cachexia. The content of ZAG between body fluids and tissues was interrelated. The content of ZAG in tumor had a stronger correlation with body fluids than fat tissue suggesting that tumor tissue may be the principle source of ZAG in gastrointestinal cancer patients. |
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