Subject(s)
Diagnosis , Education, Medical , Obesity , Physical Examination/methods , Body Mass Index , Breast Neoplasms/diagnosis , Clinical Competence , Female , Humans , Male , Risk FactorsABSTRACT
Colorectal cancer (CRC) expresses a hypoglycosylated (abnormal) form of MUC1 different than MUC1 expressed in normal colon, which elicits antibodies in patients with CRC. This form of MUC1 is expressed in other abnormal but non-malignant lesions in the colon, such as adenomatous polyps, precursors to CRC. Estimates of the prevalence of anti-MUC1 antibodies in subjects with these lesions are lacking. We evaluated IgM and IgG anti-MUC1 antibodies in 148 subjects with non-advanced adenomas (NAA), advanced adenomas (AA), colorectal cancer, hyperplastic polyps (HPP), and normal controls. We hypothesized that the prevalence of anti-MUC1 antibodies would increase along the adenoma-carcinoma sequence as more dysplastic tissues express more abnormal MUC1. Anti-MUC1 IgM was found in 5/47 (10.6%) of normals, 5/45 (11.1%) of NAA, 7/47 (14.9%) of AA, and 4/20 (20.0%) of CRC (p=0.70). The prevalence of anti-MUC1 IgG was 8/47 (17.0%) of normals, 14/45 (31.1%) of NAA, 14/47 (29.8%) of AA, and 6/20 (30.0%) of CRC (p=0.36). We found no significant differences in the prevalence of anti-MUC1 antibodies between subjects along the adenoma-carcinoma sequence. However, in an exploratory analysis, the median normalized anti-MUC1 IgG OD level of the combined abnormal groups (NAA, AA, CRC) was significantly higher than the normals (0.045 OD vs. 0.030 OD; p=0.017). Our data support further studies into the potential role of anti-MUC1 immunity in preventing progression of premalignant colon lesions to colon cancer.
Subject(s)
Adenoma/immunology , Antibodies, Neoplasm/blood , Colorectal Neoplasms/immunology , Immunity, Humoral/immunology , Mucin-1/immunology , Adenoma/diagnosis , Case-Control Studies , Colorectal Neoplasms/diagnosis , Disease Progression , Enzyme-Linked Immunosorbent Assay , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , PrevalenceABSTRACT
Vaccination as an approach to control cancer growth and recurrence, also known as active-specific immunotherapy (ASI), has been successful at inducing immune responses, even in patients with advanced or metastatic disease. Clinical responses, as determined by the criteria set for chemotherapy and radiation, have been much more difficult to assess. In general, the effectiveness of ASI in advanced disease is expected to be limited. The lack of toxicity in thousands of vaccinated patients with many different tumor types, and clearly observed, albeit rare, efficacy, support the use of ASI in early disease following resection of the primary tumor or removal of precancerous lesions. This setting will permit a much more rational assessment of the long-term efficacy of ASI, as well as its toxicity. Given that ASI relies on a healthy immune system to be effective, it is also predicted to be more successful when it is employed prior to the use of standard chemotherapy. At the very least, it should be given primary consideration in situations where the role of cytotoxic chemotherapy is equivocal and patients are in need of a nontoxic alternative.