Peritoneal Collagen Type IV Concentration in Adenocarcinoma of the Gastrointestinal Tract and Its Relationship to Histological Differentiation, Metastasis, and Survival

To determine if peritoneal collagen type IV levels could serve as a parameter for predicting metastasis and the subsequent course of disease, the concentration of collagen IV in the peritoneal fluid of 85 patients with adenocarcinoma of the gastrointestinal tract, including 50 with gastric cancer and 35 with colorectal cancer, was measured radioimmunologically. The peritoneal collagen type IV levels were elevated in 13 (26%) of the patients with gastric cancer, in 8 (23%) of those with colorectal cancer, and in none of the control subjects. The mean concentration of collagen type IV in tumors characterized by peritoneal dissemination was significantly higher than that in those without metastasis; however, there were no significant differences in the collagen type IV levels between tumors with and those without liver metastasis, or between those with and those without lymph node metastasis. There was a significant correlation between the peritoneal collagen type IV level and survival time in patients with clinically evident peritoneal dissemination. A positive correlation was also found between collagen type IV and carcinoembryonic antigen levels. In conclusion, the levels of peritoneal collagen type IV provide evidence of peritoneal dissemination, and can aid in the prediction of life expectancy in patients with adenocarcinomas of the gastrointestinal tract.