Serum macrophage inhibitory cytokine-1 (MIC-1/GDF15): a potential screening tool for the prevention of colon cancer?
Menée avec des participants à l'essai Polyp Prevention Trial, cette étude suggère que la mesure du niveau sérique de la cytokine MIC-1/GDF15 pourrait être utilisée dans le cadre du dépistage du cancer colorectal pour contribuer à la détection d'adénomes
Background: Macrophage inhibitory cytokine-1 (MIC-1/GDF15) mediates NSAID protection from colonic polyps in mice and is linked to the development of colorectal carcinoma in humans. Therefore, changes in serum MIC-1/GDF15 levels could predict the presence of pre-malignant colonic polyposis and assist in population screening strategies. Methods: Serum MIC-1/GDF15 levels were measured in subjects in the Polyp Prevention Trial, where NSAID use and colon cancer risk factors were defined. Subjects had an initial adenoma removed, a repeat colonoscopy removing previously unidentified polyps, and serum MIC-1/GDF15 estimation. Three years later recurrent adenomas were identified and serum MIC-1/GDF15 levels re-estimated. The relationship between serum MIC-1/GDF15 levels and adenoma presence or recurrence was examined. Results: Serum MIC-1/GDF15 levels differed by adenoma status and were significantly related to colon cancer risk factors. Additionally, mean serum MIC-1/GDF15 levels rose with increasing numbers of adenomas present and high-risk adenoma recurrence. NSAID users had higher serum MIC-1/GDF15 concentrations, which were related to protection from adenoma recurrence. Further, adjusted serum MIC-1/GDF15 levels at final follow up were related to adenoma recurrence (highest quartile MIC-1/GDF15; OR 14.7 95%CI 3.0-73). Conclusions: These data suggest that MIC-1/GDF15 mediates at least some of the protection afforded by NSAIDs against human colonic polyposis. Further, serum MIC-1/GDF15 levels vary with the development of adnenomatous colonic polyps. Impact: Serum MIC-1/GDF15 determination may hold promise as the first serum screening test to assist the detection of pre-malignant adenomatous colonic polyposis.
Cancer Epidemiology Biomarkers & Prevention , résumé, 2011