Cholinesterase is Associated With Prognosis and Response to Chemotherapy in Advanced Gastric Cancer

Abstract

Background: Cholinesterase (CHE) is a routine serum biomarker in gastric cancer (GC). However, little research has been done on its clinical value in advanced GC. In addition, it is not clear whether it can be used as biomarker for the response and prognosis of advanced GC patients.Methods: Between Jan. 2013 and Dec. 2016, a total of 150 patients with advanced GC treated with first-line chemotherapy were admitted to Changzhou Tumor Hospital Affiliated to Soochow University. We retrospectively identified serum CHE level on the day before chemotherapy and at the end of chemotherapy and abstracted clinicopathologic features and treatment outcomes. Univariate and multivariate survival analyses were performed to assess the relationship between serum CHE levels and progression-free survival (PFS) and overall survival (OS).Results: A total of 150 advanced GC patients were included and divided into serum level ≥5,000 IU/L and serum level <5,000 IU/L. CHE level lower than 5,000 IU/L was associated with poorer PFS (HR, 1.60; 95% CI, 1.141–2.243; p = 0.006), poorer OS (HR, 1.76; 95% CI, 1.228–2.515; p = 0.002) and trend of poorer response (HR, 0.56; 95% CI, 0.272–1.129; p = 0.104). In univariate and multivariate logistic regression analysis, only liver metastasis and PS score were significantly associated with objective response (p < 0.05). The medium PFS was 8.0 months in patients with post-treatment CHE increased vs. 3.8 months in patients with CHE decreased after chemotherapy (HR, 1.82; 95% CI 1.28–2.57; p = 0.0002). The medium OS was 13.1 months in patients with increased post-treatment CHE vs. 8.1 months in patients with decreased post-treatment CHE (HR, 1.87; 95% CI 1.29–2.71; p = 0.0002).Conclusion: Advanced GC with CHE levels below 5,000 IU/L was significantly associated with poor PFS and OS. The results suggested that CHE analysis before chemotherapy was a promising prognostic marker for advanced GC.

Reduced preoperative serum choline esterase levels and fecal peritoneal contamination as potential predictors for the leakage of intestinal sutures after source control in secondary peritonitis

“…Various studies have validated sCHE as a marker of nutritional status, correlating low sCHE levels to sarcopenia and to a high nutritional risk in critically ill patients treated on ICUs [ 26 , 41 , 42 ]. Beside the critically ill, oncologic patients are another group for which malnutrition importantly influenced postoperative morbidity and mortality [ 43 , 44 ]. In patients with colorectal cancer, low sCHE levels were associated with poor 5-year overall and disease-specific survival rates [ 43 ], whereas nutritional support led to an increase in sCHE levels and in body weight [ 45 ].…”

A risk model for predicting progression of pituitary tumors by blood and clinical factors

“…Therefore, serum cholinesterase levels can be used to evaluate the severity and prognosis of the disease and is a useful clinical indicator. A variety of malignancies have bad prognoses when cholinesterase levels are reduced, such as prostate cancer (47) colorectal cancer (48) non-small cell lung cancer (49) carcinoma of stomach (50). It is crucial in determining which illnesses are benign and which ones are malignant.…”

Serum cholinesterase may independently predict prognosis in non-small-cell lung cancer

“…Existing research suggests that expression of cholinesterase is associated with response to chemotherapy in cancer patients [ 30 ]. For example, lower ChE level may predict a poorer prognosis for biliary tract cancer patients received chemotherapy of gemcitabine and cisplatin [ 31 ].…”

“…For example, lower ChE level may predict a poorer prognosis for biliary tract cancer patients received chemotherapy of gemcitabine and cisplatin [ 31 ]. Another newly published study revealed the potential value of ChE as a real-time indicator of chemotherapy performance [ 30 ]. A reasonable explanation behind this result could be that ChE was associated with multiple conditions, particularly liver function and malnutrition which are generally related to chemotherapy [ 32 ].…”