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Differences in plasma gastrin, CEA, and CA 19-9 concentration in patients with proximal and distal colorectal cancer

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Summary

Aim. We investigated whether there are differences in plasma gastrin, as compared with carcinoembryonic antigen (CEA) and cancer antigen (CA) 19-9 between patients with proximal and distal colorectal cancer. Gastrin concentration has also been analyzed, dependent on the tumor stage, in order to evaluate the possible prognostic role of this measurement.

Methods. In 50 patients with colon cancer-fasting gastrin, CA 19-9 and CEA levels were evaluated.

Results. Mean plasma-gastrin level in patients with distal tumor yielded 105.31 ± 12.5 µU/L and was significantly higher than in patients with the proximal tumor site (42.2 ± 3.1 µU/L) as well as in controls (p<0.001). No significant difference was observed between mean plasma gastrin in patients with proximal tumors and the control group. The mean CEA plasma level was significantly higher (p<0.01) in patients with distal tumors (9.1 ± 1.1 ng/mL) than in those with proximal tumors (1.48 ± 0.1 ng/mL). Similarly, the mean CA 19-9 plasma level was significantly higher (p<0.01) in patients with distal tumor (19.9 ± 2.1 U/mL) than in those with proximal tumor: 1.8 ± 0.2 U/mL. The mean gastrin plasma, CA 19-9, and CEA level was significantly higher in group of Duke’s stage C and D as compared to A and B.

Conclusion. We speculate that observed differences in gastrin concentration in patients with distal and proximal tumors may contribute to the distinct pathogenesis and biological properties of those cancers. The significance of gastrin as a marker for diagnostic or prognostic purposes in colorectal cancer requires further study.

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References

  1. Smith AM, Watson SA. Gastrin and gastrin receptor activation: an early event in the adenoma-carcinoma sequence. Gut 2000;47:820–824.

    Article  PubMed  CAS  Google Scholar 

  2. Singh P, Owila A, Varro A, et al. Gastrin gene expression is required for the proliferation and tumorigenicity of human colon cancer cells. Cancer Res 1996;56:4111–4115.

    PubMed  CAS  Google Scholar 

  3. Guo YS, Baijal M, Jin GF, et al. Growth-promoting effects of gastrin on mouse colon cancer cells in vitro: absence of autocrine efects. In Vitro Cell Dev Biol 1990;26:871–877.

    Article  PubMed  CAS  Google Scholar 

  4. Boland CR. Gastrin and colorectal neoplasia—chicken or egg or both? [Editorial]. J Clin Gastroenterol 1991;13:497–499.

    Article  PubMed  CAS  Google Scholar 

  5. Saurin JC, Rouault JP, Abello J, et al. High gastrin releasing peptide receptor mRNA level is related to tumor dedifferentiation and lymphatic vessel invasion in human colon cancer. Eur J Cancer 1999;35:125–132.

    Article  PubMed  CAS  Google Scholar 

  6. Singh P, Xu Z, Dai B, et al. Incomplete processing of progastrin expressed by human colon cancer cells: role of noncarboxyamidated gastrins. Am J Physiol 1994;266:G459-G468.

    PubMed  CAS  Google Scholar 

  7. Hartwich A, Konturek SJ, Pierzchalski P, et al. Helicobacter infection, gastrin, cyclooxygenase-2, and apoptosis in colorectal cancer. Int J Colorectal Dis 2001;16:202–210.

    Article  PubMed  CAS  Google Scholar 

  8. Watson SA, Durrant LG, Crosbie JD, et al. The in vitro growth response of primary human colorectal and gastric cancer cells to gastrin. Int J Cancer 1989;43:692–696.

    Article  PubMed  CAS  Google Scholar 

  9. Imdahl A, Eggstein S, Crone C, et al. Growth of colorectal carcinoma cells: regulation in vitro by gastrin, pentagastrin and the gastrin receptor antagonist proglumide. J Cancer Res Clin Oncol 1989;115:388–392.

    Article  PubMed  CAS  Google Scholar 

  10. D’Agostino L, Pignata S, Tritto G, et al. Hypergastrinemia in rats with azoxymethane-induced colon cancers. Int J Cancer 1995;61:223–226.

    Article  PubMed  CAS  Google Scholar 

  11. Watson SA, Michaeli D, Morris TM, et al. Antibodies raised by gastrimmune inhibit the spontaneous metastasis of human colorectal tumor AP5LV. Eur J Cancer 1999;35:1286–1291.

    Article  PubMed  CAS  Google Scholar 

  12. Warson SA, Clifford T, Sykes RE, et al. Gastrin sensitivity of primary human colorectal cancer: the effect of gastrin receptor antagonism. Eur J Cancer 1995;31:2086–2092.

    Article  Google Scholar 

  13. Romani R, Howes LG, Morris DL. Dose dependent in vivo inhibition of human colorectal cancer (LoVo) by the gastrin receptor antagonist, CI-988. Clin Exp Pharmacol Physiol 1996;438–440.

  14. Renga M, Brandi G, Paganelli GM, et al. Rectal cell proliferation and colon cancer risk in patients with hypergastrinemia. Gut 1997;41:330–332.

    Article  PubMed  CAS  Google Scholar 

  15. Malecka-Panas E, Fligiel J, Majumdar APN. Differential responsiveness of proximal and distal colonic mucosa to gastrin. Peptides 1997;18:559–565.

    Article  PubMed  CAS  Google Scholar 

  16. Malecka-Panas E, Tureaud J, Majumdar APN. Gastrin activates tyrosine kinase (Tyr-k) and phospholipase C (PLC) in isolated rat colonocytes. Acta Biochimica Polonica 1996;43:539–546.

    PubMed  CAS  Google Scholar 

  17. Charnley RM, Thomas WM, Stanley J, et al. Serum gastrin concentrations in colorectal cancer patients. Ann R Coll Surg Engl 1992;74:138–140.

    PubMed  CAS  Google Scholar 

  18. Karlin DA, McBath M, Jones RD, et al. Hypergastrinemia and colorectal carcinogenesis in the rat. Cancer Lett 1985;29:73–78.

    Article  PubMed  CAS  Google Scholar 

  19. Watson SA, Smith AM. Hypergastrinemia promotes adenoma progression in the APC (Min+/-) mouse model of familial adenomatous polyposis. Cancer Res 2001;61:625–631.

    PubMed  CAS  Google Scholar 

  20. Begos DG, Modlin IM. Gastrin and colorectal cancer. Clarifying the controversy. J Clin Gastroenterol 1994;18:189–193.

    Article  PubMed  CAS  Google Scholar 

  21. Garnett WR. Considerations for long-term use of protonpump inhibitors. Am J Health Syst Pharm 1998;55:2279–2286.

    Google Scholar 

  22. Wong K, Beardshall K, Waters CM, et al. Postprandial hypergastrinemia in patients with colorectal cancer. Gut 1991;32:1352–1354.

    Article  PubMed  CAS  Google Scholar 

  23. Mihas AA, Maliakkal RJ, Shueke M, et al. Serum gastrin levels in patients with colorectal cancer and adenomatous polyps: a prospective study. Res Commun Mol Pathol Pharmacol 1995;90:301–304.

    PubMed  CAS  Google Scholar 

  24. Yapp RG, Modlin IM, Kumar RR, et al. Gastrin and colorectal cancer: evidence against an association. Dig Dis Sci 1992;37:481–484.

    Article  PubMed  CAS  Google Scholar 

  25. Penman ID, El-Omar E, Ardill JE, et al. Plasma gastrin concentrations are normal in patients with colorectal neoplasia and unaltered following tumor resection. Gastroenterology 1994;106:1263–1270.

    PubMed  CAS  Google Scholar 

  26. Orbuch M, Venzon DJ, Lubensky IA, et al. Prolonged hypergastrinemia does not increase the frequency of colonic neoplasia in patients with Zollinger-Ellison syndrome. Dig Dis Sci 1996;41:604–613.

    Article  PubMed  CAS  Google Scholar 

  27. Seitz JF, Giovannini M, Monges G, et al. Serum gastrin levels in colorectal cancers. Evolution after treatment. Gastroenterol Clin Biol 1992;16:385–387.

    PubMed  CAS  Google Scholar 

  28. Langman J. Medical Embryology, 4th ed. Williams & Wilkins, Baltimore, MD, 1981.

    Google Scholar 

  29. Sato M, Ahnen DJ. Regional variability of colonocyte growth and differentiation in the rat. Anat Rec 1992;233:409–412.

    Article  PubMed  CAS  Google Scholar 

  30. Shioda Y, Brown WR, Ahnen DJ. Serial observation of colonic carcinogenesis in the rat. Premalignat mucosa binds Ulex europeus aglutinin. Gastroenterology 1987;92:1–8.

    PubMed  CAS  Google Scholar 

  31. Lothe RA, Peltomaaki P, Meling GI. Genomic instability in colorectal cancer. Relationship to clinicopathological variables in family history. Cancer Res 1993;53:5849–5852.

    PubMed  CAS  Google Scholar 

  32. Kim H, Jen J, Vogelstein B, et al. Clinical and pathological characteristics of sporadic colorectal carcinomas with DNA replication errors in microsatellite sequences. Am J Pathol 1994;145:148–151.

    PubMed  CAS  Google Scholar 

  33. Bulfill JA. Colorectal cancer: evidence for distinct genetic categories based on proximal and distal tumor location. Ann Intern Med 1990;113:779–788.

    Google Scholar 

  34. Elsaleh H, Joseph G, Grieu F, et al. Association of tumor site and sex with survival benefit from adjuvant chemotherapy of colorectal cancer. Lancet 2000;355:1745–1750.

    Article  PubMed  CAS  Google Scholar 

  35. Thorburn CM, Friedman GD, Dickinson CJ, et al. Gastrin and colorectal cancer: a prospective study. Gastroenterology 1998;115:275–280.

    Article  PubMed  CAS  Google Scholar 

  36. von Kleist S, Hesse Y, Kananeeh H. Comparative evaluation of tumor markers, CA 242, CA 19-9, TPA and CEA in carcinomas of the colon. Anticancer Res 1996;16:2325–2331.

    Google Scholar 

  37. Lindmark G, Bergstrom R, Pahlman L, et al. The association of preoperative serum tumour markers with Dukes stage and survival in colorectal cancer. Br J Cancer 1995;71:1090–1094.

    PubMed  CAS  Google Scholar 

  38. Nahachai V, Walker K, Sevelius H, et al. Antisecretory and serum gastrin lowering effect of endoprostil in patients with duodenal ulcer disease. Proc Natl Acad Sci USA 1987;84:7188–7192.

    Article  Google Scholar 

  39. Lamberts R, Creutzfeldt W, Struber HG, et al. Long-term omeprazole therapy in peptic ulcer disease: gastrin, endocrine cell growth and gastritis. Gastroenterology 1993;104:1356–1370.

    PubMed  CAS  Google Scholar 

  40. Hsing AW, Hansson LE, McLaughlin JK, et al. Pernicious anemia and subsequent cancer. Cancer 1993;71:745–750.

    Article  PubMed  CAS  Google Scholar 

  41. Peach HG, Barnett NE. Determinants of basal plasma gastrin levels in the general population. J Gastroenterol Hepatol 2000;15:1267–1271.

    Article  PubMed  CAS  Google Scholar 

  42. Smith AM, Watson SA, Caplin M, et al. Gastric carcinoid expresses the gastrin autocrine pathway. Br J Surg 1998;85:1285–1289.

    Article  PubMed  CAS  Google Scholar 

  43. Hollande F, Imdahl A, Mantamadiotis T. Glycine-extended gastrin acts as an autocrine growth factor in a non-transformed colon cell line. Gastroenterology 1997;113:1576–1588.

    Article  PubMed  CAS  Google Scholar 

  44. Rehfeld JF. Gastrin and colorectal cancer: a never-ending dispute? Gastroenterology 1995;108:1307–1310.

    Article  PubMed  CAS  Google Scholar 

  45. Watson SA, Durrant LG, Morris DL. Gastrin: growth enhancing effects on human g astric and colonic tumor cells. Br J Cancer 1989;59:554–558.

    PubMed  CAS  Google Scholar 

  46. Hoosein NM, Kiener PA, Curry RC, et al. Evidence for autocrine growth stimulation of cultured colon tumor cells by a gastrin/cholecystokinin-like peptide. Exp Cell Res 1990;186:15–21.

    Article  PubMed  CAS  Google Scholar 

  47. Wu J, Rao GN, Dai B, et al. Autocrine gastrins in colon cancer cells up-regulate cytochrom c oxidase Vb and down-regulate efflux of cytochrome c and activation of caspase-3. J Biol Chem 2000;275:32,491–32,498.

    CAS  Google Scholar 

  48. Singh P, Walker JP, Townsend CM, et al. Role of gastrin and gastrin receptors on the growth of transplantable mouse colon carcinoma (MC-26) in BALB/c mice. Cancer Res 1986;46:1612–1616.

    PubMed  CAS  Google Scholar 

  49. Kermorgant S, Lehy T. Glycine-extended gastrin promotes the invasiveness of human colon cancer cells. Biochem Biophys Res Commun 2001;285:136–141.

    Article  PubMed  CAS  Google Scholar 

  50. Smith JP, Solomon TE. Effects of gastrin, proglumide and somatostation on growth of human colon cancer. Gastroenterology 1988;95:1541–1548.

    PubMed  CAS  Google Scholar 

  51. Ciccotosto GD, McLeish A, Hardy KJ, et al. Expression, processing and secretion of gastrin in patients with colorectal carcinoma. Gastroenterology 1995;9:1142–1153.

    Article  Google Scholar 

  52. Fontanesi BV, Boris B, Delcio M, et al. Gastrin levels in patients with colorectal cancer. Hepato-Gastroenterology 1997;4:1082–1084.

    Google Scholar 

  53. Kikendall JW, Glass AR, Sobin LH, et al. Serum gastrin is not higher in subjects with colonic neoplasia. Am J Gastroenterol 1992;7:1394–1397.

    Google Scholar 

  54. Smith JP, Solomon TE, Wood JG. Elevated gastrin levels in patients with colon carcinomas or adenomatous polyps. Dig Dis Sci 1989;34:171–174.

    Article  PubMed  CAS  Google Scholar 

  55. Upp JR, Singh P, Townsend CM, et al. Clinical significance of gastrin receptors in human colon cancers. Cancer Res 1989;49:488–492.

    PubMed  Google Scholar 

  56. Kameyama M, Fukuda I, Imaoka S, et al. Level of serum gastrin as a predictor of liver metastasis from colorectal cancer. Dis Colon Rectum 1993;36:497–500.

    Article  PubMed  CAS  Google Scholar 

  57. Vanderstraeten EF, De Vos MM, Versieck JM, et al. Serum gastrin levels and colorectal neoplasia. Dis Colon Rectum 1995;38:172–176.

    Article  PubMed  CAS  Google Scholar 

  58. Martin EW, Kibbey WE, DiVecchia L, et al. Carcinoembryonic antigen clinical and histological aspects. Cancer 1976;37:62–81.

    Article  PubMed  Google Scholar 

  59. Livingstone AS, Hampson LG, Shuster J, et al. Carcinoembryonic antigen in the diagnosis and management of colorectal carcinoma. Arch Surg 1974;109:259–264.

    PubMed  CAS  Google Scholar 

  60. Carpelan-Holmstrom, Haglund CH, Robets PJ. Differences in serum tumor markers between colon and rectal cancer:comparison of CA 242 and carcinoembryonic antigen. Dis Col Rectum 1996;39:799–805.

    Article  CAS  Google Scholar 

  61. Joint Cancer National Insitute of Canada/American Cancer Society Investigation. A collaborative study of a test for carcinoembryonic antigen (CEA) in the sera of patients with carcinoma of the colon and rectum. Can Med Assoc J 1972;107:5–33.

    Google Scholar 

  62. Thomas P, Zamcheck N. Role of the liver in clearance and exertion of circulating carcinoembryonic antigen (CEA). Dig Dis Sci 1983;28:216–224.

    Article  PubMed  CAS  Google Scholar 

  63. Tatsuta M, Yamamura H, Iishi H, et al. Values of CA19-9 in the serum, pure pancreatic juice, and aspirated pancreatic material in the diagnosis of malignant pancreatic tumor. Cancer 1985;56:2669–2673.

    Article  PubMed  CAS  Google Scholar 

  64. Schmiegel WH, Kreiker C, Eberl W, et al. Monoclonal antibody defines CA 19-9 in pancreatic juices and sera. Gut 1985;26:456–460.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Gastroenterology Ward, Regional Hospital, Piotrkow Trybunalski, Poland

    Grzegorz Bombski & Beata Neneman

  2. Department of Biopharmacy, Medical University of Lodz, Poland

    Daria Orszulak-Michalak

  3. Department of General and Transplantational Surgery, Medical University of Lodz, Poland

    Janusz Strzelczyk & Adam Janiak

  4. Department of Digestive Tract Diseases, Medical University of Lodz, 22 Kopcinskiego St., 90-153, Lodz, Poland

    Anita Gasiorowska, Justyna Kotynia & Ewa Malecka-Panas

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  1. Grzegorz Bombski
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  2. Anita Gasiorowska
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Correspondence to Ewa Malecka-Panas.

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Bombski, G., Gasiorowska, A., Orszulak-Michalak, D. et al. Differences in plasma gastrin, CEA, and CA 19-9 concentration in patients with proximal and distal colorectal cancer. Int J Gastrointest Canc 31, 155–163 (2002). https://doi.org/10.1385/IJGC:31:1-3:155

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