Soluble intercellular adhesion molecule-1 is a prognostic marker in colorectal carcinoma

PurposeSerological tumor markers are routinely used to monitor tumor onset and progression. In colorectal carcinoma (CRC), the carcinoembryonic antigen (CEA) is roughly elevated in 50% of patients at initial diagnosis. Soluble ICAM-1 (sICAM-1) is elevated in different cancers. The aim of this study was to evaluate the prognostic relevance of sICAM-1 combined with CEA in patients with CRC.MethodsIn blood samples of 297 CRC patients, sICAM-1 was determined by ELISA and CEA by microparticle enzyme immunoassay the day before oncologic resection. Separation in patients with sICAM-1(high) and sICAM-1(low) was performed by minimum p value approach; separation in CEA normal and elevated was performed according to the established diagnostic cutoff. Clinical data were obtained from the prospective collected data from the Erlangen Registry for Colorectal Carcinomas.ResultsCancer-related 5-year survival rate of patients with sICAM-1(low) (<290ng/ml, n=208) was significantly increased (83.4%) as compared to that of patients with sICAM-1(high) (290ng/ml, n=89) (66.2%; p<0.001). Patients with normal CEA concentrations (n=199; 90.8%) showed a significantly (p<0.001) improved cancer-related 5-year survival rate compared to patients with elevated CEA concentrations (n=98; 52.1%). Moreover, high sICAM-1 was an independent risk factor (hazard ratio 1.6) in multivariate analysis. Of note, increased sICAM-1 levels, either within normal or within elevated CEA, allowed to identify high-risk subgroups, both for overall (p<0.001) and cancer-related survival (p<0.001).ConclusionApplication of a novel risk score combining CEA/sICAM-1 serum concentrations allows the identification of high-risk groups for poor survival in CRC patients.