Kynurenine and Anthranilic Acid in the Peritoneum Correlate With the Stage of Gastric Cancer Disease

Katarzyna Gęca; Karol Rawicz-Pruszyński; Radosław Mlak; Ilona Sadok; Wojciech P Polkowski; Magdalena Staniszewska

doi:10.1177/11786469211065620

Kynurenine and Anthranilic Acid in the Peritoneum Correlate With the Stage of Gastric Cancer Disease

Int J Tryptophan Res. 2022 Feb 2:15:11786469211065620. doi: 10.1177/11786469211065620. eCollection 2022.

Authors

Katarzyna Gęca¹, Karol Rawicz-Pruszyński¹, Radosław Mlak², Ilona Sadok³, Wojciech P Polkowski¹, Magdalena Staniszewska³

Affiliations

¹ Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland.
² Department of Human Physiology, Medical University of Lublin, Lublin, Poland.
³ Laboratory of Separation and Spectroscopic Method Applications, Centre for Interdisciplinary Research, Faculty of Science and Health, The John Paul II Catholic University of Lublin, Lublin, Poland.

Abstract

Background: This study aimed to assess the importance of selected kynurenines measured in peritoneal fluid, lavage washings, and blood serum in patients with advanced gastric cancer (GC) based on the clinical and pathological staging of TNM for a more precise evaluation of the stage of the disease.

Methods: Data were collected from a prospectively maintained database of all patients operated on advanced GC between July 2018 and August 2020. In total, 98 patients were eligible for the analysis according to the REMARK guidelines.

Results: Among the various kynurenines analyzed in this study, we found that the median concentration of anthranilic acid (AA) in the peritoneal lavage washings was significantly higher in patients with positive nodes (pN1-3) compared to those with negative nodes (pN0) (P = 0.0100). Based on the ROC analysis, AA showed diagnostic utility in the differentiation of the pN staging (P = 0.0047). Furthermore, there was a positive correlation between AA in peritoneal fluid with stage pN (P = 0.0116) and a positive correlation between AA in peritoneal lavage washings with stage cT (P = 0.0101). We found that the median concentration of kynurenine (Kyn) in peritoneal lavage washings was significantly higher in patients with cM1 compared to cM0 patients (P = 0.0047). Based on the ROC analysis, Kyn showed diagnostic utility in cM staging differentiation (P < 0.0001). There was a positive correlation between peritoneal Kyn and stage of cM (P = 0.0079).

Conclusions: AA and Kyn measured in peritoneal lavage indicate advanced GC and may be considered in the future as valuable adjunct tools in TNM staging of advanced GC.

Keywords: Advanced gastric cancer; anthranilic acid; kynurenine; peritoneal fluid; peritoneal lavage.