|
Back to 2015 Annual Meeting Program
the Impact of Inflammation-Based Prognostic Scores (mGPS and Nlr) on Blood Micronutrient Concentrations in Patients With Colorectal Cancer
Fiona J. Conway1, Campbell S. Roxburgh1, Dinesh Talwar2, Paul G. Horgan*1, Donald C. Mcmillan1
1Academic Unit of Surgery, University of Glasgow, Glasgow, United Kingdom; 2Department of Biochemistry, Scottish Trace Element and Micronutrient Laboratory, Glasgow, United Kingdom
Rationale: It has been reported that low blood micronutrient concentrations are associated with the development and progression of colorectal cancer (CRC). However, there is good evidence that micronutrients fall as part of the systemic inflammatory response (SIR) and markers of SIR are increasingly recognised to predict outcome independent of tumour stage. The aim of the present study was to examine the relationship between blood micronutrient concentrations, SIR and cancer-specific survival (CSS) in patients with CRC.
Methods: Blood samples were collected preoperatively in patients (N = 139) undergoing potentially curative resection for CRC between June 2004 and July 2009 for plasma retinol, vitamins B1, B2, B6, C, D and E, lutein, lycopene, carotenoids and zinc and followed up until March 2014. The SIR was evidenced by modified Glasgow Prognostic Score (mGPS combination of CRP and albumin) and the Neutrophil-Lymphocyte Ratio (NLR) in patients with CRC.
Results: Median values of vitamins A, B1, B2, B6, D and E, lutein, the carotenoids and zinc were within the laboratory reference ranges whereas vitamin C and lycopene were low or below reference ranges. There were 26 cancer-related deaths in this time period. Measurements of vitamins A, B6, lutein, lycopene, a-carotene, β-carotene and zinc were significantly lower with increasing mGPS (all p<0.05) but only vitamin C and lycopene were associated with the NLR (both p<0.05). Surprisingly, higher plasma concentrations of plasma vitamin C were associated with an elevated NLR (p=0.035). Plasma concentrations of lycopene were significantly lower in the elevated NLR group (p=0.042). On follow-up only mGPS (HR 2.25, p=0.039) and a-carotene (HR 1.02, p=0.024) were significantly associated with CSS.
Conclusions: The SIR as evidenced by the mGPS (derived from the liver), compared with the NLR (derived from myeloid tissues), was more closely related to plasma micronutrient concentrations. The mGPS was more closely associated with cancer-specific survival. Therefore, the associations between plasma micronutrient concentrations and the development and progression of CRC are, at least in part, determined by the SIR (in particular derived from the liver).
Table 1: Plasma micronutrient concentrations and mGPS
| mGPS 0
(n=91) | mGPS 1+2 Combined
(n=48) | P value | Retinol
1.0-3.0μmol/L | 1.9
(0.7-4.0) | 1.35
(0.3-16.0) | <0.001 | Vitamin B1
275-675ng/g Hb | 502
(224-877) | 367
(266-490) | 0.361 | Vitamin B2
3-748.1nmol/L | 371
(263-558) | 367
(266-490) | 0.479 | Vitamin B6
250-680pmol/g Hb | 35
(9-252) | 22
(8-86) | 0.001 | Vitamin C
15-90μmol/L | 14
(2-83) | 11
(1-196) | 0.496 | Vitamin D
25-49nmol/L | 32
(9-144) | 33
(9-101) | 0.990 | Vitamin E
12-46μmol/L | 27
(12-48) | 26
(9-53) | 0.163 | Lutein
80-200μg/L | 91
(21-607) | 70
(15-260) | 0.017 | Lycopene
100-300μg/L | 106
(17-435) | 57
(11-258) | 0.003 | α-Carotene
14-60μg/L | 31
(9-151) | 20
(3-71) | 0.031 | β-Carotene
90-310μg/L | 108
(11-862) | 64
(10-281) | 0.019 | Zinc
10-18μmol/L | 12
(8-20) | 11
(7-15) | 0.046 |
Mann Whitney Test Table 2: Plasma micronutrient concentrations and NLR | NLR<5
(n-111) | NLR>5
(n=28) | P value | Retinol
1.0-3.0μmol/L | 1.8
(0.4-16) | 1.6
(0.3-3.7) | 0.153 | Vitamin B1
275-675ng/g Hb | 506
(224-877) | 546
(292-837) | 0.739 | Vitamin B2
3-748.1nmol/L | 367
(263-558) | 359
(304-470) | 0.617 | Vitamin B6
250-680pmol/g Hb | 32
(8-252) | 31
(14-137) | 0.538 | Vitamin C
15-90μmol/L | 13
(1-83) | 30
(8-196) | 0.035 | Vitamin D
25-49nmol/L | 33
(9-144) | 28
(9-101) | 0.265 | Vitamin E
12-46μmol/L | 27
(12-53) | 25
(9-43) | 0.121 | Lutein
80-200μg/L | 87
(15-607) | 78
(21-255) | 0.507 | Lycopene
100-300μg/L | 95
(11-435) | 57
(13-241) | 0.042 | α-Carotene
14-60μg/L | 30
(9-151) | 27
(3-92) | 0.264 | β-Carotene
90-130μg/L | 95
(10-862) | 73
(12-293) | 0.326 | Zinc
10-18μmol/L | 11
(8-20) | 12
(7-16) | 0.642 |
Mann Whitney Test
Back to 2015 Annual Meeting Program
|
