| Colorectal cancer colorectal cancer(CRC)has become the third most common malignant tumors in the world. The incidence(10.56%) and mortality(7.80%)of CRC are increasing in recent years,and the mortality is in the top five in all tumors. It is reported that vitamin D intake and serum 25(OH)D levels levels are negatively correlated with the incidence of CRC. In addition, they are related to the prognosis and survival of patients, and can effectively prevent the occurrence of CRC. Studys showed that the circulating IGF1 level was one of the independent risk factors for CRC. IGFBP3 is the main carrier of IGF-1 in circulating and plays an important role in regulating the bioactivity of IGF-1. Some study found that 1,25(OH)2D3 could up-regulate the expression of IGFBP3 and suppress the activity of IGF1, in order to inhibit the mitosis of tumor the cells. Furthermore, a large number of studies have indicated that inflammation plays a very important role in the development of CRC, but the relationship between 25(OH)D and inflammation in CRC is unclear. Therefore, this study will investigate serum levels of 25(OH)D, IGFBP3, and inflammatory factors in patients with CRC, and further explore the relationship between 25(OH)D and tumor makers, IGFBP3, IGF1, inflammatory factors.ObjectiveTo investigate the relationship between 25(OH)D, IGF1, IGFBP3, inflammatory factors by detecting their serum levels, and explore their effect on clinical pathological characteristics of patients. We hope to provide the evidence for the prevention strategy and understanding of the etiology of CRC.Contents and Methods1. Total of 150 patients with colorectal cancer(CRC) as cases and 120 control subjects recruited in this case-control study. Controls were matched with the patients with respect to age and gender. Clinical data and laboratory indexes of recruited subjects and pathological data of CRC patients were collected between March 2012 and March 2015 at Tianjin union medicine center. Detected serum levels of 25(OH)D, IGFBP3, IGF1 and other indexes of the above subjects, comparing the differences between CRC patients and healthy controls, and analyzed changes of their serum levels in patients with CRC. Then analyzed the relationship between serum levels of 25(OH)D, IGFBP3, IGF1, IGF1/IGFBP3 and clinical pathological characteristics.2. 50 hospitalized patients with CRC and 25 healthy controls who matched with respect to age and gender were selected. Clinical data and laboratory indexes of recruited subjects and pathological data of CRC patients were collected. Their serum levels of 25(OH)D, interferon(INF)- gamma, tumor necrosis factor(TNF)- alpha, interleukin(IL)-10, IL-6, IL-4, IL-2 and were detected. First, we analyzed changes of the above indexes of CRC patients. Then we examined the relationship between these indexes and clinical characteristics of patients with CRC, and explored the association between serum 25(OH)D and INF-γ, TNF-, IL-10, IL-6, IL-4, and IL-2 levels.Results1. In our study,we found that serum levels of 25(OH)D in patients with CRC was lower than that in healthy controls. Serum 25(OH) D levels decreased with age, and which was higher in males than females. There were no significant differences with serum 25(OH)D levels and the clinical characteristics of patients with CRC including tumor size, stage, differentiation of tumor cell, lymph node transfer, the primary site of the tumor, pathological type and infiltration. Serum CEA levels of non-ulcer group,high and middle cell differentiation, clinical stage ofⅠ-Ⅱ period,without lymph node metastasis group were significantly lower than that of ulcer group,poorly cell differentiation, the clinical stage of Ⅲ-Ⅳ period, lymph node metastasis group. The level of serum CEA was inversely proportional to the concentration of 25(OH) D.2. The serum 25(OH)D concentrations of the normal control group and CRC patients in IGFBP3 lower level group were significantly lower than the higher level group. Serum IGFBP3 concentration of control group was significantly higher than CRC patients, but there was no obvious difference between gender, different age groups. Circulating IGF1 levels of men were significantly higher than women,but there was no obvious difference between control group and patients with CRC. Both IGF1 levels and IGF1 / IGFBP3 ratio decreased with age in control group and CRC group. According to the comparison with tumor size, primary site, generally type, clinical stage, cell differentiation, cell infiltration and lymph node metastasis, the results showed that IGF1 / IGFBP3 ratio of tumor primary site in rectum was obviously higher than that of in the colon, the levels of circulating IGF-1 in the group tumor cells in high and middle differentiation was significantly lower than that in poor differentiation group, serum IGFBP3 level was significantly higher in the group tumor cell had breakthrough muscle layer than that without breaking, whereas the IGF1 / IGFBP3 ratio was significantly lower than without breaking.3. The levels of TNF-α, IL-10 and IL-6 in CRC group were significantly higher than those in normal control group, the difference was statistically significant. The level of inflammatory factors like IFN-γ, TNF-α, IL-10, IL-4, IL-6 and IL-2 in the comparison with the pathological factors, the difference was not statistically significant. The levels of inflammatory factors such as IFN-γ, TNF-α, IL-10, IL-6, IL-4 and IL-2 were compared between the 25(OH)D higher and lower levels groups, the difference was not statistically significant.Conclusions:1. Serum levels of 25(OH)D in patients with CRC was lower than that in healthy controls. The level of serum CEA was inversely proportional to the concentration of 25(OH) D. Combined detection of serum 25(OH)D and CEA levels for patient have very important clinical values in the diagnosis of CRC.2. The serum level of 25(OH)D decreased with the decrease of IGFBP3 level.Circulating IGFBP3,IGF1 levels, and IGF1/IGFBP3 ratios may provide the reference value to evaluate the degree of infiltration and differentiation of tumor cells for clinical CRC patients.3.TNF-γ, IL-10, IL-6, IL-2and 25(OH)D have a certain role in predicting tumor size, pathological stage and differentiation. We didn’t see any significant difference between serum 25(OH) D levels and above inflammatory factors. |
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