Serum Chitinase Activity Predicts The Metastasis Of Colorectal Cancer

Background and Objective:Predicting the prognosis and metastasis of colorectal cancer(CRC)is important and difficult.Chitinase activity is a biomarker for DNA damage and telomere dysfunction,which related to the progression of cancer.CHI3L1,one member of the Chitinase family,has been implicated in several cancers,such as glioblastoma,breast cancer,and ovarian cancer.However,no study involving the value of the whole Chitinase family activity in prediction of cancer metastases and prognosis of CRC patients.In this study we evaluated the value of Chitinase activity in predicting the occurrence of metastasis and prognosis in patients with CRC.Methods:The Chitinase activity in blood serum was assayed by enzyme-linked immunosorbent assay for 527 samples,including 386 CRC patients,100 age-matched healthy controls and 40 primary liver cancer patients.The clinicopathologic data were collected and all these patients were prospectively followed up.In vitro Transwell experiment was done to evaluate migration of the colon cancer cells.Results:The serum Chitinase activity was significantly up-regulated in CRC patients compared with age-matched healthy control(Medium,IQR;20.7 ng/?L,16.9-24.6 ng/?L vs.17.2 ng/?L,15.44-21.3 ng/?L,P<0.0001).The Chitinase activity was up-regulated in CRC patients with synchronous liver metastasis compared to CRC patients without metastasis(20.7,16.9-24.6),and primary liver cancer patients(20.5,17.4-24.0).Kaplan-Meier analysis showed the higher expressed Chitinase activity and CEA level were significant associated with poor survival.Univariate analysis showed Chitinase activity,CEA and lymph node status significantly associated with liver metastases.Further multivariate analysis revealed that Chitinase activity was independent risk factor(HR,3.24,p=0.001)predicting liver metastases as well as lymph node metastases status.Chitinase activity is superior to lymph node metastases status for predicting the liver metastases,the combination of Chitinase activity and lymph node metastases status increased the accuracy of prediction of liver metastases after radical resection.(Accuracy AUC=0.746,p=0.454E-011).In vitro Transwell experiment showed that increased Chitinase activity promoted the cell migration of CRC cell lines(RKO and SW48)in culture.Conclusion:Blood Chitinase activity could predict the prognosis and occurrence of metastasis in CRC patients.Moreover,the combination of Chitinase activity and N stage increased the power of predicting the occurrence of metastasis of CRC patients.Inhibiting the Chitinase activity may provide a new treatment of metastases of colorectal cancer.