Pre- and Perioperative Inflammatory Biomarkers in Older Patients Resected for Localized Colorectal Cancer: Associations with Complications and Prognosis

Abstract

The association between pre- and perioperative inflammatory biomarkers, major complications, and survival rates after resection of colorectal cancer (CRC) in older patients is largely unknown. The aim was to investigate age-dependent differences in these associations. Serum CRP, IL-6, and YKL-40 were measured preoperatively and on the first and second day after resection of CRC (stages I–III) in 210 older (≥70 years) and 191 younger patients (<70 years). The results from the complications was presented as an odds ratio (OR, with a 95% confidence interval (CI)) with logistic regression. Results from the mortality rates were presented as a hazard ratio (HR, with a 95% CI) using Cox proportional hazards regression. The preoperative inflammatory biomarkers were higher in the older vs. the younger patients. The risk of complications was increased in older patients with a high preoperative CRP (OR = 1.25, 95% CI 1.03–1.53), IL-6 (OR = 1.57, 95% CI 1.18–2.08), and YKL-40 (OR = 1.66, 95% CI 1.20–2.28), but not in younger patients. Mortality was higher in younger patients with high preoperative YKL-40 (HR = 1.66, 95% CI 1.06–2.60). This was not found in older patients. Elevated preoperative inflammatory biomarkers among older patients were associated with an increased risk of complications, but not mortality. Preoperative inflammatory biomarkers may be useful in assessing the risk of a complicated surgical course in older patients with CRC.

Upregulation of YKL-40 Promotes Metastatic Phenotype and Correlates with Poor Prognosis and Therapy Response in Patients with Colorectal Cancer

“…Preclinical data were validated in a training set of hCRC samples, which confirmed the significant upregulation of YKL-40 transcriptional levels in adenocarcinoma. We also found higher YKL-40 levels in the sera of CRC patients than in healthy subjects, in line with data presented by other studies [ 67 , 69 ]. Our findings underline the clinical significance of YKL-40, as it could efficiently distinguish CRC cases from controls with an AUC of 85.6 (95% CI: 73.7–97.4%, p = 0.0002) for YKL-40 mRNA in tissues and an AUC of 78.7 (95% CI: 69.0–88.4%, p = 0.000004), with cutoff values of 0.58 and 0.47, respectively.…”

“…This is in line with a recent study of CRC highlighting a significant increase in the cell proliferation rate in YKL-40.OE cells associated with p53 downregulation and EGFR upregulation [ 52 ]. Although the involvement of YKL-40 in cell proliferation has been extensively investigated in physiological conditions or in various inflammation diseases [ 67 , 68 ], our findings provide evidence for this mechanism in CRC cells.…”

The Many Faces of G Protein-Coupled Receptor 143, an Atypical Intracellular Receptor

“…Chromosome Xp22.2-22.3, where the OA1 gene is localized, is a colorectal cancer risk locus ( Spatz et al, 2004 ; Benoît et al, 2007 ; McBride, 2016 ). Colorectal cancer is the second leading cause of cancer death worldwide with 881 000 estimated deaths in 2018 ( Bray et al, 2018 ; Dolin et al, 2021 ). This type of cancer is highly associated with age ( Ellison et al, 2018 ; Siegel et al, 2020 ; Dolin et al, 2021 ).…”

“…Colorectal cancer is the second leading cause of cancer death worldwide with 881 000 estimated deaths in 2018 ( Bray et al, 2018 ; Dolin et al, 2021 ). This type of cancer is highly associated with age ( Ellison et al, 2018 ; Siegel et al, 2020 ; Dolin et al, 2021 ). Aside from an unhealthy lifestyle, colorectal cancer can also develop due to genetic mutations ( Munteanu and Mastalier, 2014 ).…”

The Prognostic Value of Pre-Treatment Circulating Biomarkers of Systemic Inflammation (CRP, dNLR, YKL-40, and IL-6) in Vulnerable Older Patients with Metastatic Colorectal Cancer Receiving Palliative Chemotherapy—The Randomized NORDIC9-Study

“…CRP is an acute phase protein and a non-specific marker of tissue damage and inflammation. High CRP in patients with stage I-III CRC is associated with increased risk for postoperative complications, relapse, and mortality [ 18 , 19 , 20 ]. In patients with mCRC, high baseline CRP is associated with shorter survival [ 21 ].…”