Postoperative change of anti-Thomsen-Friedenreich and Tn IgG level: The follow-up study of gastrointestinal cancer patients

Abstract

AIM:To study the influence of tumor removal on the serum level of IgG antibodies to tumor-associated Thomsen-Friedenreich (TF), Tn carbohydrate epitopes and xenogeneic αGal, and to elucidate on the change of the level during the follow-up as well as its association with the stage and morphology of the tumor and the values of blood parameters in gastrointestinal cancer. METHODS: Sixty patients with gastric cancer and 34 patients with colorectal cancer in stages Ⅰ-Ⅳ without distant metastases were subjected to followup. The level of antibodies in serum was determined by the enzyme-linked immunosorbent assay (ELISA) using synthetic polyacrylamide (PAA) glycoconjugates. Biochemical and haematological analyses were performed using automated equipment. RESULTS: In gastrointestinal cancer, the TF antibody level was found to have elevated significantly after the removal of G3 tumors as compared with the preoperative level (u = 278.5, P < 0.05). After surgery, the TF and Tn antibody level was elevated in the majority of gastric cancer patients (sign test, 20 vs 8, P < 0.05, and 21 vs 8, P < 0.05, respectively). In gastrointestinal cancer, the elevated postoperative level of TF, Tn and αGal antibodies was noted in most patients with G3 tumors (sign test, 22 vs 5, P < 0.01; 19 vs 6, P < 0.05; 24 vs 8, P < 0.01, respectively), but the elevation was not significant in patients with G1 + G2 resected tumors. The postoperative follow-up showed that the percentage of patients with G3 resected tumors of the digestive tract, who had a mean level of anti-TF IgG above the cutoff value (1.53), was significantly higher than that of patients with G1 + G2 resected tumors (χ 2 = 3.89, all patients; χ 2 = 5.34, patients without regional lymph node metastases; P < 0. No positive delayed-type hypersensitivity reaction in skin test challenges with TF-PAA in any of the fifteen patients, including those with a high level of anti-TF IgG, was observed. CONCLUSION: The surgical operation raises the level of anti-carbohydrate IgG in most patients, especially in those with the G3 tumor of the gastrointestinal tract. The follow-up demonstrates that after surgery the low preoperative level of TF antibodies may be considerably increased in patients with the carcinoma in its early stage but remains low in its terminal stages. The stageand morphology-dependent immunosuppression affects the TF-antibody response and may be one of the reasons for unresponsiveness to the immunization with TF-antigens.

The Relation of the Level of Serum Anti-TF, -Tn and -Alpha-Gal IgG to Survival in Gastrointestinal Cancer Patients

“…This is in accordance with the results obtained by other researchers who used the erythrocyte-derived TF-antigen in the assay of anti-TF antibodies 12. The elevated postoperative levels of anti-TF, -Tn and -αGal IgG observed in the follow-up were associated with the stage and morphology of the tumor 13. The anti-αGal antibodies may be involved in the progression of autoimmune diseases 7 but have been studied insufficiently with reference to cancer.…”

“…According to our preliminary data, no difference in survival was demonstrated in relation to anti-MUC1 IgM and anti-TF IgM antibodies 16. The high level of anti-carbohydrate IgG and/or its postoperative elevation observed in some patients with cancer 13 may be a sign of an adaptive immune response which is indicative of the switching of antibodies to the IgG-class.…”

“…The study was focused on IgG antibodies because we observed a high anti-carbohydrate IgG in some long-term survivors 11, 13. According to our preliminary data, no difference in survival was demonstrated in relation to anti-MUC1 IgM and anti-TF IgM antibodies 16.…”

“…The present study demonstrated that the lower preoperative level of anti-TF IgG (TF-WR) in the examined subgroups (Stage III, N1-2 and G3) is associated with worse survival. The postoperative level of anti-TF, -Tn and -αGal antibodies in patients with the G3 tumor of the gastrointestinal tract had increased to a different degree 13. However, this positive dynamics was not associated with survival.…”

“…The level of IgG antibodies to glycoconjugates in the serum of patients changed after surgery 13. We delineated the change of antibody level as a quadratic function Y = a + bX + cX 2 , where Y is the level of antibodies, X is the time in months, coefficient a is the factor characterizing the initial level of antibodies, b and c are the factors characterizing its dynamics ( b is the change of antibody level by month and c is the acceleration of antibody level change).…”