N-TERMINAL PEPTIDE OF TYPE-III PROCOLLAGEN - A POSSIBLE PREDICTOR OF COLORECTAL-CARCINOMA RECURRENCE

BACKGROUND. The first step of colorectal carcinoma spread depends on t he ability of the tumor cells to degrade and invade the extracellular matrix (ECM). The objectives of the current study were to evaluate the serum pattern of laminin, C-terminal peptide of Type I (PIP), and N-t erminal peptide of Type III (PIIIP) procollagens, markers of ECM synth esis, in the follow-up of patients after resection for colorectal carc inoma and to evaluate their role in predicting local recurrence or met astases. METHODS. A total of 32 patients who had undergone resection f or colorectal carcinoma were followed for a median period of 24 months (range, 6-36 months). Every 3 months, laminin, PIP, and PIIIP were me asured in the sera together with the tumor markers carcinoembryonic an tigen (CEA), CA 19-9, and tissue plasminogen activator (TPA). Twenty-o ne patients (Group 1) had no signs of recurrence, whereas the remainin g 11 (Group 2) developed hepatic (n = 7) or pulmonary (n = 4) metastas es. RESULTS. No variations were observed in either group for laminin, CEA, CA 19-9, or TPA, whereas significant increases in PIP and PIIIP w ere observed in both groups 3 months after surgery. The increase in PI P and PIIIP at the S-month follow-up was significantly greater in Grou p 1 than in Group 2. The difference between values at 3 months and bas al values enabled a discrimination between Group 1 and Group 2, with a sensitivity of 36% and 91% and a specificity of 71% and 71% for PIP a nd PIIIP, respectively. CONCLUSIONS. The authors believe PIIIP is usef ul as an early prognostic indicator of recurrence in the follow-up of patients who have undergone radical resection for colorectal carcinoma . (C) 1997 American Cancer Society.