Published in Cancer Detection and Prevention 2000; 24(Supplement 1).

Alpha-L-fucosidase activity as a useful prognostic indicator in serum of colorectal cancer patients with Dukes' stages B or C Comparison with other prognostic tumor markers

D Ayude BSc, FJ Rodríguez-Berrocal PhD, M Acuña BSc, MF Montenegro BSc, VS Martínez-Zorzano PhD, A de Carlos PhD, M Páez de la Cadena PhD

Dept Biochemistry, Genetics and Immunology, University of Vigo, Vido, Spain,

AIM: The aim of this study was to examine the prognostic value of the preoperative serum alpha-L-fucosidase activity (AFU) in colorectal cancer (CRC) and its comparison with other prognostic predictors. METHODS: Preoperative blood was collected from 137 unselected patients operated on for CRC. Only 91 patients, who follow the inclusion and exclusion criteria, were included in the survival analysis and were followed-up for a mean time of 38 months. Several clinicopathologic features (age, sex, stage of the tumor, location...) and tumor markers (AFU, CEA, CA 19.9...) were studied. AFU activity was measured using a fluorometric enzymatic assay. Univariate and multivariate analysis were carried out using Kaplan-Meier, Log Rank and Cox tests. RESULTS: In a previous study, we have found that the AFU activity was decreased in serum of CRC patients (P<0.001). The diagnostic value of AFU was determined, establishing the cut-off in 5.6 U/mL. Furthermore, we have detected a significant relationship between AFU activity and the type of metastasis (P=0.034). In the present study, a survival analysis was carried out, establishing three groups with different prognosis in function of the AFU activity, having as final status the recurrence or the death. A similar result was obtained when the analysis was made for patients in Dukes' stage B or C, separately. The relationship between the clinicopathologic features, or the tumor markers, and the survival was also determined and a multivariate analysis was carried out. CONCLUSIONS: Preoperative serum AFU activity could be used as an independent prognostic factor of the recurrence and death in CRC. Furthermore, it can be used to distinguish patients with Dukes' stages B or C with different prognosis.

KEY WORDS: Alpha-L-fucosidase, colorectal cancer, serum, tumor markers, prognosis, survival, recurrence, death.

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Paper presented at the International Symposium on Impact of Biotechnology on Cancer Diagnostic & Prognostic Indicators; Geneva, Switzerland; October 28 - 31, 2000; in the section on prognostic markers.