Emiş Deniz AKBULUT, Serpil ERDOĞAN, Serkan AKBULUT, Fatma Meriç YILMAZ

Mide ve Kolorektal Kanserli Hastalarda Serum Sistatin C Düzeyi ve CEA, CA 19-9 ile İlişkisinin İncelenmesi

Amaç: Böbrek fonksiyonun bir belirteci olarak bilinen sistatin C’nin tümör gelişiminde inhibör etki gösterdiği düşünülmektedir. Çalışmada bilinen böbrek hastalığı olmayan mide ve kolorektal kanserli olgularla sağlıklı bireylerin serum sistatin C düzeyleri arasındaki olası farkın, serum karsinoembriyonik antijen (CEA) ve karbohidrat antijen 19-9 (CA19-9) düzeyleri arasındaki ilişkinin incelenmesi amaçlanmıştır.Materyal ve metod: Çalışmaya serum kreatinin konsantrasyonu referans aralığı içerisinde yer alan ve tahmini glomerüler filtrasyon hızı (eGFH) >60 mL/dk olan mide (n=35) ve kolorektal kanserli (n=35) hastalar ile bilinen herhangi bir sistemik hastalığı olmayan sağlıklı bireyler (n=40) dahil edilmiştir. CEA ve CA 19-9 testleri kemilüminesans temelli immün yöntemle (Beckman Coulter UniCel® DxI 800 Immunoassay System) Sistatin C analizi ise partikül yüzeyi genişletilmiş immünotürbidimetrik yöntem (Roche Diagnostics Cobas® Modular P®) kullanılarak yapılmıştır.Bulgular: Mide, KRK (kolorektal kanser) ve kontrol grupları arasında serum kreatinin konsantrasyonu açısından önemli fark izlenmezken (p=0,571) sistatin C düzeyi hasta gruplarında kontrol grubuna göre anlamlı olarak daha yüksek izlenmiştir (p<0,001). Çoklu değişkenli lojistik regresyon analizinde sistatin C düzeyinin yüksek olması üzerinde sırasıyla; kreatinin düzeyi ve kanser hastası olmanın etkili olduğu bulunmuştur. Kreatinindeki her 0,1 mg/dL’lik artış sistatin C düzeyinin yüksek olma ihtimalini 2,531 kat (%95 güven aralığı: 1,562-4,100) arttırmaktadır (p<0,001). Ayrıca kontrol grubuna göre kanserli grupta sistatin C’nin yüksek olma ihtimalinin 20,384 kat (%95 güven aralığı: 2,992-142,196) fazla olduğu bulunmuştur (p=0,002). Hasta grubunda yer almak, yaş, cinsiyet ve kreatinin konsantrasyonu gibi faktörlerin etkileri göz önünde bulundurulduğunda CEA ve CA 19-9 yüksekliği ile serum sistatin C düzeyi arasında anlamlı ilişki izlenmemiştir (p>0,05). Sonuç: Mide veya kolorektal kanserli olgularda serum sistatin C düzeyinin böbrek fonksiyonunun yanısıra kanser varlığından da etkilenebileceği gözlenmiştir.Anahtar Kelimeler: Sistatin C, Katepsin, Mide Kanseri, Kolorektal Kanser

Anahtar Kelimeler:

sistatin C, katepsin, mide kanseri, kolorektal kanser

Evaluation of Serum Cystatin C Levels And Its Relation with CEA, CA 19-9 in Patients with Gastric and Colorectal Cancer

Background: Cystatin C, a marker of kidney function, is thought to have inhibiting effects in tumor growth. In the study comparing serum concentrations of cystatin C among gastric, colorectal cancer patients, controls and determination of its relation between serum CEA and CA 19-9 levels are aimed.Materials and Methods: Gastric cancer patients (n=35), colorectal cancer patients (n=35) and healthy subjects (n=40) without any known systemic disease were included in the study. None of the participants had previously known kidney disease, serum creatinine level out of reference interval or eGFR<60 mL/min. Serum CEA and CA 19-9 levels were analysed using chemiluminescence immunoassay on Beckman Coulter UniCel® DxI 800 Immunoassay System and cystatin C was analysed with particle-enhanced turbidimetric immunoassay on Roche Diagnostics Cobas® Modular P® analyzer.Results: Cystatin C levels were significantly higher in patients’ sera (p<0.001) while there was no significant difference between groups for serum creatinine (p=0.571). Multivariate logistic regression analysis revealed that creatinine level and participation in the patient groups were the determinants of the elevated serum cystatin C concentration, respectively. Each 0.1 mg/dL elevation in creatinine level increased the possibility of having high cystatin C level 2.531 times (95% CI: 1.562-4.100). Besides the possibility of finding high cystatin C levels were 20.384 times more in the patient group (95% CI:2.992-142.196). No significant relation between CEA, CA 19-9 and cystatin C was observed when participation in patient groups, age, sex and creatinine concentration were taken into consideration (p>0.05).Conclusion: Serum cystatin C concentrations of gastric and colorectal cancer patients may be affected due to the presence of cancer besides kidney function.

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