Systemic inflammation in colorectal cancer: Underlying factors, effects, and prognostic significance

World J Gastroenterol. 2019 Aug 21;25(31):4383-4404. doi: 10.3748/wjg.v25.i31.4383.

Abstract

Systemic inflammation is a marker of poor prognosis preoperatively present in around 20%-40% of colorectal cancer patients. The hallmarks of systemic inflammation include an increased production of proinflammatory cytokines and acute phase proteins that enter the circulation. While the low-level systemic inflammation is often clinically silent, its consequences are many and may ultimately lead to chronic cancer-associated wasting, cachexia. In this review, we discuss the pathogenesis of cancer-related systemic inflammation, explore the role of systemic inflammation in promoting cancer growth, escaping antitumor defense, and shifting metabolic pathways, and how these changes are related to less favorable outcome.

Keywords: C-reactive protein; Cachexia; Chemokine; Colorectal cancer; Cytokine; Glasgow prognostic score; Inflammation; Metastasis; Prognosis.

Publication types

  • Review

MeSH terms

  • Biomarkers / blood
  • Biomarkers / metabolism
  • C-Reactive Protein / analysis
  • C-Reactive Protein / immunology
  • C-Reactive Protein / metabolism
  • Cachexia / immunology*
  • Cachexia / metabolism
  • Cachexia / mortality
  • Colorectal Neoplasms / complications
  • Colorectal Neoplasms / immunology
  • Colorectal Neoplasms / mortality*
  • Cytokines / blood
  • Cytokines / immunology
  • Cytokines / metabolism
  • Humans
  • Inflammation / blood
  • Inflammation / immunology*
  • Inflammation / metabolism
  • Inflammation Mediators / blood
  • Inflammation Mediators / immunology
  • Inflammation Mediators / metabolism
  • Metabolic Networks and Pathways / immunology
  • Prognosis
  • Tumor Escape
  • Wasting Syndrome / immunology*
  • Wasting Syndrome / metabolism
  • Wasting Syndrome / mortality

Substances

  • Biomarkers
  • Cytokines
  • Inflammation Mediators
  • C-Reactive Protein