Background: It has been shown that local chronic inflammation may lead to colorectal carcinogenesis via adenomatous polyps. Tumor necrosing factor-alpha (TNF-alpha), interleukin-6 (IL-6) and C-reactive protein (CRP) are biomarkers of inflammation and indicators of the immune response to tumors. Their elevated levels were observed in patients with colon adenomas, however their clinical significance is unclear.
Methods: The study included sixty patients with the colorectal adenomatous polyps found on colonoscopy and confirmed pathologically. The control group consisted of 30 individuals with no positive findings on colonoscopy. The aim of our study was to determine the serum levels of TNF-alpha, IL-6 and CRP in colorectal adenomas patients and to assessed the relationships between them and colorectal adenoma location, dysplasia grading, histological type, and size.
Results: One hundred nine adenomas (6-40 mm of size) were found in 60 study patients. The average age of patients with multiple polyps was significantly higher than of those with single pathologies (61.1 vs 56.7 years respectively (p < 0.05)). The prevalence of colon adenomas were observed in distal part of colon (83.3%), compared to the proximal part (16.7%; p < 0.01). The TNF-alpha concentration was similar in both group (24.51 +/- 13.50 pg/ml versus 29.61 +/- 14.94 pg/ml; p > 0.05) and not related to clinical data of patients. In contrast, CRP serum concentrations were higher in patients with adenomas located proximally (8.674 +/- 9.19 microg/ml) compared to control group (4.94 +/- 5.53 microg/ml; p < 0.05). There was also no differences between IL-6 serum level in patients with colon adenomas (19.80 +/- 7.44 pg/ml) and control group (20.46 +/-11.83 pg/ml; p > 0.05). Analyzed cytokines serum levels were not associated with size, number, degree of dysplasia and histological type of colon adenomas.
Conclusion: Our results indicate that CRP may be associated with development of tumors of proximal part of colon.