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Preoperative mannan-binding lectin pathway and prognosis in colorectal cancer

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Abstract

Purpose: Deficiency of the mannan-binding lectin (MBL) pathway of innate immunity is associated with increased susceptibility to infections. In patients with colorectal cancer (CRC), postoperative infection is associated with poor prognosis. The aim of the present study was to evaluate (1) the relation between the MBL pathway and postoperative infectious complications and survival of patients resected for CRC, and (2) the role of MBL in acute phase response compared to C-reactive protein (CRP). Methods: Preoperative MBL concentration, MBL-associated serine protease (MBL/MASP) activity and CRP were determined in serum from 611 patients and 150 healthy controls. The patients were observed for 8 years. Postoperative infections, recurrence and survival were recorded. Results: The MBL pathway components were increased in the patients compared with the healthy controls (p<0.0001). Low MBL levels were predictive of pneumonia (p=0.01), and pneumonia (n=87) was associated with poor survival (p=0.003; HR=1.5; 95% CI, 1.1 to 1.9). MBL and MBL/MASP activity showed no correlation with CRP (Spearman’s ρ=0.02; 95% CI, −0.06 to 0.10). Conclusion: Low preoperative MBL levels are predictive of pneumonia, which is associated with poorer survival. MBL concentration and MBL/MASP activity was not predictive of other postoperative infections or long-term prognosis, and showed no correlation with CRP.

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Acknowledgements

The authors thank Birgitte Sander Nielsen, Anette Hansen and Lisbeth Jensen for inspiration and skillful work during handling and analysis procedures. Furthermore, we wish to thank the Department of Clinical Biochemistry for performing the CRP analyses. The study received financial support from The Kornerup Fund, The Hede-Nielsen Family Fund, The Walter and O. Kristiane Christensen Fund, The Sven and Ina Hansen Fund, The Beckett Fund, The Aage and Johanne Louis-Hansen Fund, The Ingeborg Roikjer Fund, The Terese Maria Hansen Fund, The Sophus and Astrid Jacobsen Fund, The Karen A. Tolstrup Fund, The Ragnhild Ibsen Fund, The Lily Benthine Lund Fund, The Danish Pharmacy Foundation of 1991, The Danish Medical Research Fund, and The Danish Cancer Society (grant #DP 02012).

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Authors and Affiliations

  1. Department of Surgical Gastroenterology 435, Hvidovre University Hospital, Kettegard Allé 30, 2650, Hvidovre, Denmark

    Henriette Ytting, Ib Jarle Christensen & Hans Jørgen Nielsen

  2. Institute of Medical Microbiology and Immunology, University of Aarhus, Nordre Ringgade 1, 8000, Aarhus, Denmark

    Jens Christian Jensenius & Steffen Thiel

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  1. Henriette Ytting
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  2. Ib Jarle Christensen
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  5. Hans Jørgen Nielsen
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Correspondence to Henriette Ytting.

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Ytting, H., Christensen, I.J., Jensenius, J.C. et al. Preoperative mannan-binding lectin pathway and prognosis in colorectal cancer. Cancer Immunol Immunother 54, 265–272 (2005). https://doi.org/10.1007/s00262-004-0594-9

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  • DOI: https://doi.org/10.1007/s00262-004-0594-9

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