PERITONEAL COLLAGEN TYPE-IV CONCENTRATION IN ADENOCARCINOMA OF THE GASTROINTESTINAL-TRACT AND ITS RELATIONSHIP TO HISTOLOGICAL DIFFERENTIATION, METASTASIS, AND SURVIVAL

To determine if peritoneal collagen type IV levels could serve as a pa rameter for predicting metastasis and the subsequent course of disease , the concentration of collagen IV in the peritoneal fluid of 85 patie nts with adenocarcinoma of the gastrointestinal tract, including 50 wi th gastric cancer and 35 with colorectal cancer, was measured radioimm unologically. The peritoneal collagen type IV levels,were elevated in 13 (26%) of the patients with gastric cancer, in 8 (23%) of those with colorectal cancer, and in none of the control subjects, The mean conc entration of collagen type IV in tumors characterized by peritoneal di ssemination was significantly higher than that in those without metast asis; however, there were no significant differences in the collagen t ype IV levels between tumors with and those without liver metastasis, or between those with and those without lymph node metastasis. There w as a significant correlation between the peritoneal collagen type IV l evel and survival time in patients with clinically evident peritoneal dissemination. A positive correlation was also found between collagen type IV and carcinoembryonic antigen levels. In conclusion, the levels of peritoneal collagen type IV pro,ide evidence of peritoneal dissemi nation, and can aid in the prediction of life expectancy in patients w ith adenocarcinomas of the gastrointestinal tract.