Clinical Significance of Serum Glutamine Level in Patients with Colorectal Cancer

Nutrients. 2019 Apr 21;11(4):898. doi: 10.3390/nu11040898.


Limited studies have assessed the associations of pretreatment serum glutamine level with clinicopathological characteristics and prognosis of colorectal cancer (CRC) patients. This study focuses on clarifying the clinical significance of baseline serum glutamine level in CRC patients. We retrospectively examine 123 patients with newly diagnosed CRC between 2009 and 2011. The associations of pretreatment serum glutamine level with clinicopathological characteristics, proinflammatory cytokines, overall survival (OS), and progression-free survival (PFS) were analyzed. We executed univariate and multivariate analyses to assess the associations between serum glutamine level and clinicopathological variables able to predict survival. Low glutamine levels were associated with older age, advanced stage, decreased albumin levels, elevated carcinoembryonic antigen levels, higher C-reactive protein levels, higher modified Glasgow prognostic scores, and higher proinflammatory cytokine levels. Furthermore, patients with low glutamine levels had poorer OS and PFS than those with high glutamine levels (p < 0.001 for both). In multivariate analysis, pretreatment glutamine level independently predicted OS (p = 0.016) and PFS (p = 0.037) in CRC patients. Pretreatment serum glutamine level constitutes an independent prognostic marker to predict survival and progression in CRC patients.

Keywords: colorectal cancer; inflammation; progression; serum glutamine level; survival.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Albumins / metabolism
  • Biomarkers, Tumor
  • C-Reactive Protein / metabolism
  • Carcinoembryonic Antigen / blood
  • Colorectal Neoplasms / blood*
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology
  • Cytokines / blood
  • Disease Progression
  • Female
  • Glutamine / blood*
  • Humans
  • Inflammation / blood
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Survival Analysis
  • Young Adult


  • Albumins
  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Cytokines
  • Glutamine
  • C-Reactive Protein