Literature DB >> 24484717

Metabolic syndrome and colorectal cancer: is hyperinsulinemia/insulin receptor-mediated angiogenesis a critical process?

Jane Jijun Liu1, Mihaela Druta1, David Shibata2, Domenico Coppola3, Ivette Boler4, Abul Elahi2, Richard R Reich5, Erin Siegel6, Martine Extermann7.   

Abstract

OBJECTIVE: Components of metabolic syndrome (MS) have been individually linked to colorectal cancer risk and prognosis; however, an understanding of the dominant mechanisms is lacking.
MATERIALS AND METHODS: Twenty-one patients (10 MS; 11 non-MS) with resectable colorectal cancer were prospectively enrolled. Patients were classified for MS by the World Health Organization criteria and tested for circulating vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), insulin-like growth factor-1 (IGF-1), fasting insulin, and tumor expression of IGF-1 receptor (IGF-1R), insulin-receptor (IR) and receptor for advanced glycation end-products (RAGE). Circulating markers were re-tested 6 months after surgery.
RESULTS: The MS group had significantly higher baseline and post-operative fasting insulin levels (p < 0.001 and 0.003). No differences were observed in circulating IL-6, VEGF, IGF-1 and free IGF-1. By immunohistochemistry (IHC), IGF-1R expression was significantly higher in tumor vs. normal tissues (p < 0.001) while IR expression showed no difference. Interestingly, 64% of tumors demonstrated high IR positivity in the vessels within or surrounding the tumor stroma, but not in the vessels away from the tumor. By reverse transcription polymerase chain reaction (RT-PCR), tumor IGF-1R over-expression (80%) was confirmed, but there was no difference between MS and non-MS patients. Tumor RAGE over-expression was found in 67% of patients and was equally distributed between the two groups.
CONCLUSIONS: Hyperinsulinemia was the only significant factor distinguishing patients with colorectal cancer who have MS. The preferential over-expression of IR in the peri-tumoral microvessels suggests that hyperinsulinemia might contribute to colorectal cancer growth by enhancing angiogenesis.
Copyright © 2013 Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Colorectal cancer; Elderly; Hyperinsulinemia; IGF-1; Insulin receptor; Metabolic syndrome; Tumor vasculature

Mesh:

Substances:

Year:  2013        PMID: 24484717      PMCID: PMC4527303          DOI: 10.1016/j.jgo.2013.11.004

Source DB:  PubMed          Journal:  J Geriatr Oncol        ISSN: 1879-4068            Impact factor:   3.599


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