Every year 160,000 newly registered cases of colorectal cancer (CRC) are diagnosed in the United States and 57,000 patients die from this disease, making it the second leading cause of mortality from cancer pathology in adults. The disease begins as benign adenomatous polyps. Then it is transformed into an adenoma with high-grade dysplasia, which can lead to the development of invasive cancer. It is interesting to note early diagnosis of the disease is extremely important due to the efficacy of treatment in the early stages of CRC. It has been known that the condition of the connective tissue contributes to tumor progression by influencing tumor invasion and metastasis. However, the role of exctracellular matrix in CRC, as well as its potential prognostic role of metabolites that characterize the state of the extracellular matrix in oncoprocess, which affects the large intestine, should be made more precise. The study was designed to evaluate features of connective tissue in patients with colorectal cancer. The significant increase in elastase activity was found in patients with colorectal cancer. The analysis of its activity in patients with colorectal cancer showed that the highest elastase activity was observed in patients with the 4th stage of the disease. The lowest activity was revealed in patients with the 2nd stage of colorectal cancer. It was found that patients with colorectal cancer had significantly elevated values of collagenolytic activity in comparison with healthy individuals. Dynamics of changes in collagenolytic activity in serum depending on the stage of the disease was similar to the dynamics of changes in the activity of elastase. The elevation of collagenolytic activity in patients with colorectal cancer indicates enhanced proteolysis of collagen in this pathology. Thus, the increased collagenolytic activity of serum against the background of activated elastase favors rapid degradation of structural protein components of connective tissue, particularly collagen and elastin, which may make a further contribution to disease progression, tumor invasion, and formation of metastases. Proteolytic processes that involve components of extracellular matrix are more intense in the later stages of colorectal cancer. It was found that the disintegration of the extracellular matrix included not only the protein component. The evaluation of carbohydrate components of connective tissue showed an increase in both glycosaminoglycans and one of the components of glycosaminoglycans, namely hyaluronic acid, in patients with colorectal cancer. Taking into account the results stated above, we can make a conclusion that colorectal cancer is accompanied by the active destruction of the extracellular matrix, more severe in the later stages. The accelerated catabolism of components of the extracellular matrix may facilitate tumor invasion and formation of metastases. Analysis shows that these indices may serve as a basis for prognostic assessment of the severity of this disease and reflects the important role of extracellular matrix in the pathogenesis and formation of metastases in colorectal cancer.
Keywords: colorectal cancer, collagenolytic activity, glycosaminoglycans, elastase, hyaluronic acid
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