Serum M30 levels are associated with survival in advanced gastric carcinoma patients

Background: Cytokeratin 18 (CK-18) is a cytoskeleton protein of epithelial cells which are released into the circulation during necrotic or apoptotic cell death. M30 detects caspase-cleaved neo-epitope of CK-18; whereas M 65 measures whole length intact protein. We aimed to evaluate the prognostic significance of serum M65 and M30 levels in patients with gastric carcinoma. Methods: Thirty eight patients with advanced disease were included in the study. Thirty-two healthy people were chosen as control group. Serum M65 and M30 levels were measured by quantitative ELISA method. Results: Serum M65 levels were found significantly elevated in patients compared to control group (385.7 +/- 280.6 vs. 200.2 +/- 164.5, p = 0.002). Serum M30 levels were significantly increased in patients compared to the control group (204.6 +/- 245 vs. 106.5 +/- 17.5, p = 0.03). Patients with metastatic disease had significantly higher levels of serum M30 compared to patients with locally advanced disease (267.1 +/- 296.1 vs. 102.3 +/- 53.2, p = 0.03). Serum M30 and M65 levels were evaluated in respect to survival. Best cut-off value for the prediction of death for M30 antigen level was 83.8 U/L. Patients with higher M30 levels had significantly shorter median survival compared to patients' lower serum M30 levels. However, there was no impact of serum M65 levels on survival. Serum M30 levels and clinical stage were found as the strongest variables with independent prognostic value for overall survival. Discussion: These results suggest that serum M65 and M30 levels were elevated in patients with advanced gastric carcinoma patients. Serum M30 levels can be helpful to predict tumor load and also survival. (C) 2010 Elsevier By. All rights reserved.