CIRCULATING INTERCELLULAR-ADHESION MOLECULE-1 AND E-SELECTIN LEVELS IN GASTRIC-CANCER

A diversity oi adhesive interactions occur between the cancer cell and host extracellular matrix which potentiate neoplastic expansion and m etastatic dissemination. In miscellaneous malignant diseases, tumour p rogression has been observed to be associated with alterations in adhe sion molecule expression. Recently, circulating soluble intercellular adhesion molecules have been identified. In this study, serum levels o f soluble intercellular adhesion molecule-1 (sICAM-1) and soluble E-se lectin (sE-selectin) were determined in patients with gastric cancer. The study group consisted of 27 patients with previously untreated gas tric adenocarcinoma. Four patients had stage II, two patients stage II I and 21 patients stage IV disease according to the TNM classification . Nineteen patients had distant metastasis. The sera obtained from 18 healthy volunteers served as controls. Serum sICAM-1 and sE-selectin c oncentrations were determined by enzyme-linked immunosorbent assay (EL ISA). In addition, we also studied other tumour-associated antigens, i .e. CEA and CA 19-9, Serum sICAM-1 levels were significantly increased in patients with gastric cancer (P < 0.0001), However, sE-selectin le vels did not differ from the controls, sICAM-1 concentrations were als o significantly higher in patients with distant metastasis and periton eal spread (P = 0.0045 and P = 0.0157 respectively), whereas sE-Select in levels were elevated only in patients with peritoneal metastasis (P = 0.033). Serum concentrations of sICAM-1 and sE-selectin correlated with CEA levels (P = 0.0013 and P = 0.003 respectively). Elevated leve ls of sE-selectin were associated with poorer prognosis (P = 0.0099), whereas sICAM-1 had no significant impact on survival. Our results sug gest that increased sICAM-1 serum levels may reflect widespread diseas e and contribute directly to the progression of gastric cancer. Furthe r investigation of the molecular mechanisms of adhesive tumour-host in teractions may lead to a better understanding of the natural history o f gastric cancer.