<strong>Background and Purpose</strong>: Neoadjuvant chemoradiation (CRT) is the mainstay treatment for locally advanced rectal carcinoma. However, the response is varied due to many factors, including tissue hypoxia. Osteopontin (OPN) is an emerging endogen hypoxic marker with significant correlation towards tumor pO2, also a more accurate chronic hypoxic marker compared to carbonic anhydrase IX (CAIX), glucose transporter 1 (GLUT1), and lactate dehydrogenase A (LDHA); but as far as we know there is no research that measured OPN quantity in rectal cancer tissue and correlated it with tumor shrinkage response in neoadjuvant CRT. <strong>Materials and Method</strong>: Fourteen patients that met the inclusion and exclusion criteria were analyzed retrospectively. Imaging was evaluated for tumor shrinkage percentage and categorized based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. OPN level quantitative results from rectal cancer tissue were obtained using ELISA method. <strong>Results</strong>: The mean OPN concentration was 0.568 ± 0.26 ng/mL. There was a significant strong negative correlation (<em>r </em>= −0.630, <em>p </em>= 0.016) between the OPN level and tumor shrinkage. OPN cut off value of ≥0.538 ng/mL predicted non-responsiveness of tumor shrinkage in neoadjuvant CRT with 100% sensitivity and 81.8% specificity. <strong>Conclusion</strong>: Hypoxia occurred in locally advanced rectal carcinoma patients. Higher level of OPN correlates negatively with tumor shrinkage, proved worse response of CRT given.<p> </p>
Abstract:This study was performed to determine the correlation between aldehyde dehydrogenase-1A1 (ALDH1A1) level and tumor shrinkage after chemoradiation in locally advanced rectal cancer. This is a retrospective study of 14 locally advanced rectal cancer patients with long course neoadjuvant chemoradiation. The ALDH1A1 level was measured using ELISA from paraffin embedded tissue. Tumor shrinkage was measured from computed tomography (CT) scan or magnetic resonance imaging (MRI) based on Response Evaluation Criteria in Solid Tumor v1.1 (RECIST v1.1). The mean of ALDH1A1 level was 9.014 ± 3.3 pg/mL and the mean of tumor shrinkage was 7.89 ± 35.7%. Partial response proportion was 28.6%, stable disease proportion was 50% and progressive disease proportion was 21.4%. There was a significantly strong negative correlation (r = -0.890, p < 0.001) between ALDH1A1 and tumor shrinkage. In conclusion, tumor shrinkage in locally advanced rectal cancer after preoperative chemoradiation was influenced by ALDH1A1 level. Higher level of ALDH1A1 suggests decreased tumor shrinkage after preoperative chemoradiation.
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