Kivonat:
Many findings indicate that measuring the serum concentration of
soluble 70-kD heat shock protein (soluble HSP70) may provide
important information in cardiovascular, inflammatory, and
pregnancy-related diseases; however, only scarce data are
available in cancer. Therefore, using a commercial ELISA kit, we
measured soluble HSP70 concentration in the sera of 179 patients
with colorectal cancer. We investigated the relationship between
soluble HSP70 concentration and mortality, during 33.0 (24.4-
44.0)months long follow-up. High (>1.65 pg/ml, median
concentration) soluble HSP70 level was a significant (hazard
ratio: 1.88 (1.20-2.96, p=0.005) predictor of mortality during
the follow-up period. When we compared the soluble HSP70 levels
in patients with non-resected primary tumors as compared to
those who were recruited into the study 4-6 weeks after the
tumor resection they were found to be significantly (p=0.020)
higher in the former group. Since the patients with non-resected
primary tumors had also distant metastasis and died early, we
limited the further analysis to 142 patients with no distant
metastasis at the beginning of the follow-up. This association
remained significant even after multiple Cox-regression analysis
had been performed to adjust the data for age and sex (p=0.028);
age, sex, and TNM-T stage (p=0.041); age, sex, and TNM-N stage
(p=0.021); age, sex, and histological grade (p=0.023); or age,
sex, and tumor localization (p=0.029). Further analysis showed
that the significant association between high HSP70 levels and
poor survival is in the strongest in the group of <70-year-old
female patients (HR: 5.52 (2.02-15.15), p=0.00l), as well as in
those who were in a less advanced stage of the disease at
baseline. These novel findings indicate that the serum level of
soluble HSP70 might prove a useful, stage-independent prognostic
marker in colorectal cancer without distant metastasis.