Clinical significance of fibronectin expression in colorectal cancer.

We measured the serum and urinary levels of fibronectin (FN) in 113 patients with colorectal cancer (CRC) - 15 with synchronous hepatic metastases, 21 with metachronous hepatic metastases and 77 with no hepatic metastases - as well as in 40 controls, with the aim of determining if FN can be used as a marker of CRC invasion or metastasis and its clinical significance. Urinary FN levels were significantly higher in patients with CRC than in the controls, and both urinary and serum FN levels rose with cancer progression. Patients positive for FN tended to have a more advanced disease. High levels of FN expression in both urine and serum showed a sensitivity of 80%, specificity of 33.3%, accuracy of 66.6% and positive predictive value of 75% for the diagnosis of metachronous hepatic metastases. These results indicate that FN levels increase with the progression of CRC, that FN expression in urine and serum is a useful marker of the degree of disease advancement, and that FN may play a part in cancer growth and development.