Basic Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2016; 8(8): 607-614
Published online Aug 15, 2016. doi: 10.4251/wjgo.v8.i8.607
Plasma chitinase 3-like 1 is persistently elevated during first month after minimally invasive colorectal cancer resection
H M C Shantha Kumara, David Gaita, Hiromichi Miyagaki, Xiaohong Yan, Sonali AC Hearth, Linda Njoh, Vesna Cekic, Richard L Whelan
H M C Shantha Kumara, David Gaita, Hiromichi Miyagaki, Xiaohong Yan, Sonali AC Hearth, Linda Njoh, Vesna Cekic, Richard L Whelan, Division of Colon and Rectal Surgery, Department of Surgery, Mount Sinai West Hospital, New York, NY 10019, United States
Hiromichi Miyagaki, Department of Gastroenterological Surgery, Osaka University, Osaka 565-0871, Japan,
Richard L Whelan, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
Author contributions: Shantha Kumara HMC contributed to the conception, design, sample processing, analysis and interpretation of data, revision of the articles; Gaita D contributed to the manuscript writing, collection of human material and clinical data; Miyagaki H, Yan X and Hearth SAC contributed to human sample collection, processing, analysis and interpretation of data; Njoh L contributed to the statistical analysis, interpretation of data; Cekic V contributed to collection of human material and clinical data; Whelan RL contributed to the conception, design, interpretation of data, critical revision of the article; all authors drafted the article and made critical revisions and approved the final version of the article to be published.
Supported by Mr. Wade Thompson and family donation funds to the Divisions of Colon and Rectal surgery, Department of Surgery, Mount Sinai West Hospital, New York, NY 10019.
Institutional review board statement: This study was reviewed and approved by Mount Sinai Hospital, New York IRB.
Informed consent statement: All subjects in this study provided research study consent.
Conflict-of-interest statement: All authors have no conflicts of interest or financial ties to disclose.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Richard L Whelan, MD, Professor of Surgery, Chief, Division of Colon and Rectal Surgery, Department of Surgery, Mount Sinai West Hospital, Suite 7B, 425 West, 59th Street, New York, NY 10019, United States. rwhelan@chpnet.org
Telephone: +1-212-5238172 Fax: +1-212-5238857
Received: July 10, 2015
Peer-review started: July 14, 2015
First decision: October 30, 2015
Revised: May 27, 2016
Accepted: June 1, 2016
Article in press: June 3, 2016
Published online: August 15, 2016
Processing time: 396 Days and 2.7 Hours
Abstract

AIM: To assess blood chitinase 3-like 1 (CHi3L1) levels for 2 mo after minimally invasive colorectal resection (MICR) for colorectal cancer (CRC).

METHODS: CRC patients in an Institutional Review Board approved data/plasma bank who underwent elective MICR for whom preoperative (PreOp), early postoperative (PostOp), and 1 or more late PostOp samples [postoperative day (POD) 7-27] available were included. Plasma CHi3L1 levels (ng/mL) were determined in duplicate by enzyme linked immunosorbent assay.

RESULTS: PreOp and PostOp plasma sample were available for 80 MICR cancer patients for the study. The median PreOp CHi3L1 level was 56.8 CI: 41.9-78.6 ng/mL (n = 80). Significantly elevated (P < 0.001) median plasma levels (ng/mL) over PreOp levels were detected on POD1 (667.7 CI: 495.7, 771.7; n = 79), POD 3 (132.6 CI: 95.5, 173.7; n = 76), POD7-13 (96.4 CI: 67.7, 136.9; n = 62), POD14-20 (101.4 CI: 80.7, 287.4; n = 22), and POD 21-27 (98.1 CI: 66.8, 137.4; n = 20, P = 0.001). No significant difference in plasma levels were noted on POD27-41.

CONCLUSION: Plasma CHi3L1 levels were significantly elevated for one month after MICR. Persistently elevated plasma CHi3L1 may support the growth of residual tumor and metastasis.

Keywords: Colorectal cancer; Recurrence; Minimally inasive colorectal resection; Chitinase 3-like 1; Metastasis

Core tip: Colorectal cancer (CRC) resection surgery is well known to be associated with short lived immunosuppression and transient plasma protein changes. We have documented that a second set of blood protein alterations that last for 3 to 5 wk after CRC; interestingly, all of these proteins play a role in angiogenesis. This group of pro-angiogenic proteins includes vascular endothelial growth factor, placental growth factor, angiopoietin-2, monocyte chemo-attractant protein-1 and matrix metalloproteinase 2. Our published data further confirms that pro-angiogenic postoperative plasma from cancer patients stimulates in vitro endothelial cell proliferation, migration, and invasion. In this manuscript we are presenting data to demonstrate that a pro-angiogenic protein, chitinase 3-like 1, in CRC patients remain elevated for month after minimally invasive colorectal resection.