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Local calprotectin production in colorectal cancer and polyps—active neutrophil recruitment in carcinogenesis

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Aim

The aim of this study is to examine the expression level and localization of calprotectin in cancer tissue, tumor-adjacent mucosa, and polyps in colonic biopsies. Calprotection expression was correlated with neutrophil infiltration, markers of bacteremia, and systemic inflammation.

Materials and methods

Patients with colorectal cancer (n = 28) and adenoma (n = 38) were compared with healthy controls (n = 33). Calprotectin expression levels were measured by ELISA, and its localization was visualized by immunohistochemistry and correlated with the degree of neutrophil infiltration (visualized by Esterase staining). The expression of tumor necrosis factor (TNF)-alpha, procalcitonin, endotoxemia, carcinoembryonic antigen (CEA), and C-reactive protein was also investigated.

Results

Mucosal calprotectin was expressed in significantly higher concentrations in carcinoma (94.2 ± 31.2 ng/mg total protein) and adenoma (122.8 ± 60.3 ng/mg total protein) in comparison with mucosal biopsies from healthy controls (20.4 ± 5.4 ng/mg total protein), tumor-adjacent mucosa from patients with colorectal carcinoma (21.6 ± 5.1 ng/mg total protein), and adenoma (45 ± 14.6 ng/mg total protein, all p < 0.05). Immunohistochemistry showed calprotectin reactivity mainly in granulocytes and macrophages with only singular reactive epithelial cells. Positive staining (quantified by the number of positive cells per square millimeter) was markedly increased in carcinoma tissue (85 ± 21.5) and in adenoma (67.5 ± 20) as compared with tumor-adjacent epithelia (18.8 ± 4.3, p = 0.0007, p = 0.003, respectively), and there was a highly significant correlation, r = 0.89, p = 0.001) between calprotectin staining and neutrophil infiltration. No significant differences were found in the systemic levels of TNF-alpha, procalcitonin, and endotoxemia, whereas CEA and C-reactive protein levels were significantly higher in the cancer group (p < 0.05).

Conclusion

Our results support the evidence that increased calprotectin expression is an early step in the neoplastic transformation during colorectal carcinogenesis. Moreover, its expression is closely related to an inflammatory response and points out a possible biological link between inflammation and neoplastic transformation in colorectal cancer.

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Acknowledgements

We wish to thank Mr Volker Ott, MD, for his skilful assistance in manuscript writing.

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Author notes

  1. Nils Homann

    Present address: Department of Medicine, Klinikum Wolfsburg, Sauerbruchstrasse 5–7, Wolfsburg, Germany

Authors and Affiliations

  1. First Department of Medicine, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany

    Kim Luley, Hendrik Lehnert & Nils Homann

  2. Institute of Pathology, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany

    Frank Noack

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  1. Kim Luley
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Correspondence to Nils Homann.

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Luley, K., Noack, F., Lehnert, H. et al. Local calprotectin production in colorectal cancer and polyps—active neutrophil recruitment in carcinogenesis. Int J Colorectal Dis 26, 603–607 (2011). https://doi.org/10.1007/s00384-011-1165-0

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