Growth/differentiation factor 15 (GDF-15) as new potential serum marker in patients with metastatic colorectal cancer

Article type: Research Article

Authors: Vocka, Michal^{a; *} | Langer, Daniel^b | Fryba, Vladimir^c | Petrtyl, Jaromir^d | Hanus, Tomas^e | Kalousova, Marta^f | Zima, Tomas^f | Petruzelka, Lubos^a

Affiliations: [a] Department of Oncology, First Faculty of Medicine, Charles University, and General University Hospital in Prague, Prague 2, 128 08, Czech Republic | [b] Surgery Department, Second Faculty of Medicine, Charles University, and Military University Hospital in Prague, Prague, Czech Republic | [c] 1st Department of Surgery – Department of Abdominal, Thoracic Surgery and Traumatology, First Faculty of Medicine, Charles University, and General University Hospital in Prague, Prague 2, 128 08, Czech Republic | [d] 4t⁢h Department of Internal Medicine – Department of Gastroenterology and Hepatology, First Faculty of Medicine, Charles University, and General University Hospital in Prague, Prague 2, 128 08, Czech Republic | [e] Department of Urology, First Faculty of Medicine, Charles University, and General University Hospital in Prague, Prague 2, 128 08, Czech Republic | [f] Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University, and General University Hospital in Prague, Prague 2, 128 08, Czech Republic

Correspondence: [*] Corresponding author: Michal Vocka, Department of Oncology, First Faculty of Medicine, Charles University, and General University Hospital in Prague, U Nemocnice 499/2, Prague 2, 128 08, Czech Republic. Tel.: +420 224 962 219; Fax: +420 224 961 716; E-mail: [email protected].

Abstract: BACKGROUND: GDF-15 is a protein belonging to the transforming growth factor beta superfamily that has a role in regulating inflammatory and apoptotic pathways. High level GDF-15 in tumor tissues and plasma correlate with an increased risk of recurrence and reduced overall survival. OBJECTIVE: The aim of this study was to screen GDF-15 capacity to detecting metastatic CRC and compare it with standard tumor markers CEA and CA19-9. METHODS: We collected serum samples from 97 patients with metastatic colorectal cancer and 79 samples from healthy controls. Serum levels of GDF-15, CEA and CA19-9 were measured by immunochemically. A Kaplan-Meier curve was applied for analysis of survival rates, and a log-rank was used for univariate analysis. RESULTS: Serum levels of GDF-15 were significantly higher in patients with colorectal cancer compared to healthy controls (p< 0.001). In addition, serum levels of GDF-15 correlated with extent of liver involvement and patients with higher GDF-15 levels had significantly worse outcome (p< 0.0001). CONCLUSIONS: Our results show GDF-15 as an effective biomarker in patients with metastatic colorectal cancer with the same sensitivity as CEA. In addition, GDF-15 levels strongly correlate with extension of liver involvement in contrast with CEA.

Keywords: GDF-15, colorectal cancer, biomarker, survival

DOI: 10.3233/CBM-170792

Journal: Cancer Biomarkers, vol. 21, no. 4, pp. 869-874, 2018