Serum laminin is an independent prognostic factor in colorectal cancer

Purpose: We investigated laminin, an important extracellular matrix component, to elucidate mechanisms of invasion and metastasis in colorectal cancer, and whether preoperative serum laminin is a predictive marker of high-risk groups. Methods: We measured preoperative serum laminin levels using a two-step sandwich enzymeimmunassay (EIA) method in 205 patients with colorectal cancer, 109 with colon cancer and 96 with rectal cancer, 52 with hepatic metastases, and 153 with no hepatic metastases. Results: Mean serum laminin in patients with colon cancer was 606.3 +/- 260.2 ng/ml, significantly higher than that of 258.0 +/- 92.0 ng/ml in normal controls ( P< 0.0001). The positive rate was higher at 89.3% for laminin vs. 38.0% for carcinoembryonic antigen (CEA) and 19.5% for CA19-9. Mean serum laminin in patients with hepatic metastases was 668.0 +/- 274.7 ng/ml, significantly higher than that of 585.2 +/- 252.5 ng/ml in patients without hepatic metastases P= 0.0472). Survival rates were significantly lower in the high (>= 520 ng/ml) than in the low laminin group (< 350 ng/ml; P= 0.0451). Univariate and multivariate analysis, using Cox's proportional hazard regression model, showed serum laminin is an independent prognostic factor in colorectal cancer, along with hepatic, pulmonary and peritoneal metastases. Conclusion: Preoperative serum laminin levels are a useful predictive marker of high-risk groups in colorectal cancer.