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, 102 (4), 665-72

Plasma MIC-1 Correlates With Systemic Inflammation but Is Not an Independent Determinant of Nutritional Status or Survival in Oesophago-Gastric Cancer

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Plasma MIC-1 Correlates With Systemic Inflammation but Is Not an Independent Determinant of Nutritional Status or Survival in Oesophago-Gastric Cancer

R J E Skipworth et al. Br J Cancer.

Abstract

Background: Macrophage inhibitory cytokine-1(MIC-1) is a potential modulator of systemic inflammation and nutritional depletion, both of which are adverse prognostic factors in oesophago-gastric cancer (OGC).

Methods: Plasma MIC-1, systemic inflammation (defined as plasma C-reactive protein (CRP) of > or =10 mg l(-1) or modified Glasgow prognostic score (mGPS) of > or =1), and nutritional status were assessed in newly diagnosed OGC patients (n=293). Healthy volunteers (n=35) served as controls.

Results: MIC-1 was elevated in patients (median=1371 pg ml(-1); range 141-39 053) when compared with controls (median=377 pg ml(-1); range 141-3786; P<0.001). Patients with gastric tumours (median=1592 pg ml(-1); range 141-12 643) showed higher MIC-1 concentrations than patients with junctional (median=1337 pg ml(-1); range 383-39 053) and oesophageal tumours (median=1180 pg ml(-1); range 258-31 184; P=0.015). Patients showed a median weight loss of 6.4% (range 0.0-33.4%), and 42% of patients had an mGPS of > or =1 or plasma CRP of > or =10 mg l(-1) (median=9 mg l(-1); range 1-200). MIC-1 correlated positively with disease stage (r(2)=0.217; P<0.001), age (r(2)=0.332; P<0.001), CRP (r(2)=0.314; P<0.001), and mGPS (r(2)=0.336; P<0.001), and negatively with Karnofsky Performance Score (r(2)=-0.269; P<0.001). However, although MIC-1 correlated weakly with dietary intake (r(2)=0.157; P=0.031), it did not correlate with weight loss, BMI, or anthropometry. Patients with MIC-1 levels in the upper quartile showed reduced survival (median=204 days; 95% CI 157-251) when compared with patients with MIC-1 levels in the lower three quartiles (median=316 days; 95% CI 259-373; P=0.036), but MIC-1 was not an independent prognostic indicator.

Conclusions: There is no independent link between plasma MIC-1 levels and depleted nutritional status or survival in OGC.

Figures

Figure 1
Figure 1
Box plot showing increased plasma MIC-1 concentration in oesophago-gastric cancer patients when compared with the controls (P<0.001).
Figure 2
Figure 2
Box plot showing increasing plasma MIC-1 concentration with increasing distal situation of the primary tumour (P=0.015).
Figure 3
Figure 3
Box plot showing increasing plasma MIC-1 concentration with worsening tumour grade (P=0.010).
Figure 4
Figure 4
Box plot showing increasing plasma MIC-1 concentration with worsening disease stage (P=0.002).
Figure 5
Figure 5
Box plot showing increasing plasma MIC-1 concentration with increasing modified Glasgow Prognostic Score (P<0.001).
Figure 6
Figure 6
Dot plot of MIC-1 vs CRP (linear r2=0.059).
Figure 7
Figure 7
Kaplan–Meier plot of survival of oesophago-gastric cancer patients according to plasma MIC-1 concentration. Patients with MIC-1 concentrations in the upper quartile showed worsened survival (median 204 days; 95% CI 157–251) when compared with patients with MIC-1 concentrations in the lower three quartiles (median 316 days; 95% CI 259–373; P=0.036, log-rank test).

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