Colorectal cancer metastatic phenotype stimulates production by fibroblasts of N-terminal peptide of type III collagen: clinical implications for prognosis

In this study we assessed whether the serum levels of the N-terminal peptid e of type III collagen (PIIIP), an index of type III collagen synthesis, ar e influenced by colorectal cancer stage, and whether "in vitro" fibroblast growth and PIIIP production could be altered by tumor tissues obtained from metastatic and nonmetastatic colorectal cancer. 208 colorectal cancer pati ents (115 colon and 93 rectum) were studied; 54 were stage I, 62 stage II, 37 stage III and 55 stage IV. PIIIP serum levels were significantly higher in stage IV as compared to all other patient groups. The 5-year survival of stage I, stage II, stage III and stage IV patients were 87%, 88%, 32% and 20%, respectively. In the subgroup of stage I and stage II patients conside red together, PIIIP ( > 0.5 U/ml), but not CEA (> 5 mug/l) serum levels, we re predictive for survival. Fibroblast growth was significantly inhibited, while PIIIP production was significantly enhanced, when these cells were co nditioned with colorectal cancer homogenates obtained from patients with di stant metastases, than from those without distant metastases. In conclusion , colorectal tumors, when metastatic, stimulate fibroblasts' PIIIP synthesi s and the serum levels of this peptide might predict patients' outcome afte r radical surgery. (C) 2001 Elsevier Science B.V. All rights reserved.