Serum Levels of Galectin-9 are Increased in Cervical Cancer Patients and are Higher in Advanced Clinical Stages

Abstract

Purpose Cervical cancer (CC) is the second most frequent cancer in undeveloped countries. Serum biomarkers could be useful for evaluation of the treatment response and as a complementary means to improve diagnosis. The expression of galectin-9 is altered in cancer tissue, and higher concentrations are found in the serum of cancer patients. The objectives of this study were (a) to determine the serum galectin-9 concentration in patients with intraepithelial lesions and CC, (b) to determine if the concentration was related to the clinicopathological characteristics and (c) to determine if the galectin-9 concentration was related to its expression level in tumour tissue. Patients and Methods In all, 222 serum samples from women with different diagnoses, including premalignant lesions and CC, as well as samples from women with normal cytology were included in the study. The serum galectin-9 concentration was determined by ELISA. To evaluate the expression level of galectin-9 in CC tissue, immunohistochemistry was performed in 34 CC biopsy specimens. Results The galectin-9 concentration in the serum of CC patients (8.171 ng/mL) was increased compared with serum from women with normal epithelia (4.654 ng/mL) and those with low-grade (4.806 ng/mL) and high-grade (5.354 ng/mL) intraepithelial lesions (p value < 0.0001). The area under the ROC curve considering the CC group and the control group was 0.882. The optimal cut-off value was ≥6.88 ng/mL, the specificity obtained was 100%, and the sensitivity was 68.2%. In the CC group, the analysis of the clinical stage showed an increase of galectin-9 in the advanced stage IV group. Serum galectin-9 was not related to the level of galectin-9 expression in tissue, which suggests that galectin-9 is not secreted by tumour cells. Conclusion The serum galectin-9 concentration is related to cancer progression, as the level of this protein is higher in patients with advanced-stage disease.

Response to Article “Serum Levels of Galectin-9 are Increased in Cervical Cancer Patients and are Higher in Advanced Clinical Stages” [Letter]

“…However, a recent study by Beyer et al, concluded that the presence of galectin-9 could be a prognosis marker for cervical cancer. 5 Contradicting this, a previous study reported that the expression of galectin-9 in the tumor cell represented a beneficial response toward the given therapies, 3 which slightly delivered a similar message to this particular study by Reyes-Vallejo et al 4 Hopefully, there will be a clear finding regarding the expression or the concentration of galectin-9 together with other galectin family proteins which may play significant roles in cancer development and prognosis. Therefore, a question worth asking is if there is any correlation to human papillomavirus (HPV) infection affecting the expression of galectin-9 or other galectin family proteins in the cells?…”

“…However, a recent study by Beyer et al, concluded that the presence of galectin-9 could be a prognosis marker for cervical cancer. 5 Contradicting this, a previous study reported that the expression of galectin-9 in the tumor cell represented a beneficial response toward the given therapies, 3 which slightly delivered a similar message to this particular study by Reyes-Vallejo et al 4 …”

“…The study regarding galectin-9 as a biomarker for cervical cancer reported by Reyes-Vallejo et al, which was recently published, gives important information in this field. 4 The concentration of galectin-9 from serum samples was measured accurately by ELISA method, while the dissected tissue collected was stained for visualizing the expression of galectin-9 in the tissue. However, the concentration detection of galectin-8, galectin-1, and galectin-3, the other three important galectin family proteins was not included.…”

Response to Article “Serum Levels of Galectin-9 are Increased in Cervical Cancer Patients and are Higher in Advanced Clinical Stages” [Response to Letter]

“…They state the importance of detecting other galectins, in respect that we have considered to evaluate serum galectin-9 as a potential biomarker for cervical cancer because this protein plays an important role as an immunomodulator, so it could be related with the immune status of the patients and the progression of the disease. 1 The study of other serum galectins such as galectin-1, galectin-3 and galectin-8 in cervical cancer would certainly generate important information and complement the results obtained in this study.…”

Expression of Gal-9 on Dendritic Cells and Soluble Forms of TIM-3/Gal-9 in Patients Suffering from Endometriosis

“…An elevated concentration of sGal-9 was detected in the serum of patients with nasopharyngeal carcinoma in comparison with healthy subjects [ 37 ]. Reyes Vallejo et al, suggested that serum sGal-9 may participate in the progression of cervical cancer and may be a useful prognostic biomarker [ 38 ]. The accumulation of sGal-9 in the PF in our cohort of EMS patients highlights the important role of the soluble form of this lectin in the local peritoneal cavity environment.…”