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Prieto I, del Puerto-Nevado L, Gonzalez N, Portal-Nuñez S, Zazo S, Corton M, Minguez P, Gomez-Guerrero C, Arce JM, Sanz AB, Mas S, Aguilera O, Alvarez-Llamas G, Esbrit P, Ortiz A, Ayuso C, Egido J, Rojo F, Garcia-Foncillas J. Colon cancer modulation by a diabetic environment: A single institutional experience. PLoS One 2017; 12:e0172300. [PMID: 28253286 PMCID: PMC5333811 DOI: 10.1371/journal.pone.0172300] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 02/02/2017] [Indexed: 12/13/2022] Open
Abstract
Background Multiple observational studies suggest an increased risk of colon cancer in patients with diabetes mellitus (DM). This can theoretically be the result of an influence of the diabetic environment on carcinogenesis or the tumor biologic behavior. Aim To gain insight into the influence of a diabetic environment on colon cancer characteristics and outcomes. Material and methods Retrospective analysis of clinical records in an academic tertiary care hospital with detailed analysis of 81 diabetic patients diagnosed of colon cancer matched with 79 non-diabetic colon cancer patients. The impact of streptozotocin-induced diabetes on the growth of colon cancer xenografts was studied in mice. Results The incidence of DM in 1,137 patients with colorectal cancer was 16%. The diabetic colon cancer cases and non-diabetic colon cancer controls were well matched for demographic and clinical variables. The ECOG Scale Performance Status was higher (worse) in diabetics (ECOG ≥1, 29.1% of controls vs 46.9% of diabetics, p = 0.02), but no significant differences were observed in tumor grade, adjuvant therapy, tumor site, lymphovascular invasion, stage, recurrence, death or cancer-related death. Moreover, no differences in tumor variables were observed between patients treated or not with metformin. In the xenograft model, tumor growth and histopathological characteristics did not differ between diabetic and nondiabetic animals. Conclusion Our findings point towards a mild or negligible effect of the diabetes environment on colon cancer behavior, once cancer has already developed.
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Affiliation(s)
- Isabel Prieto
- Radiation Oncology, Oncohealth Institute, IIS-Fundacion Jimenez Diaz- UAM, Madrid, Spain
- * E-mail:
| | - Laura del Puerto-Nevado
- Translational Oncology Division, Oncohealth Institute, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
| | - Nieves Gonzalez
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
| | - Sergio Portal-Nuñez
- Bone and Mineral Metabolism Laboratory, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
| | - Sandra Zazo
- Pathology Department, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
| | - Marta Corton
- Department of Genetics, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
| | - Pablo Minguez
- Department of Genetics, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
| | - Carmen Gomez-Guerrero
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
| | - Jose Miguel Arce
- Health Information Management Department, Fundacion Jimenez Diaz, Madrid. Spain
| | - Ana Belen Sanz
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
| | - Sebastian Mas
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
| | - Oscar Aguilera
- Radiation Oncology, Oncohealth Institute, IIS-Fundacion Jimenez Diaz- UAM, Madrid, Spain
| | - Gloria Alvarez-Llamas
- Immunoallergy and proteomics Laboratory, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
| | - Pedro Esbrit
- Bone and Mineral Metabolism Laboratory, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
| | - Alberto Ortiz
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
| | - Carmen Ayuso
- Department of Genetics, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
| | - Jesus Egido
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
| | - Federico Rojo
- Pathology Department, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
| | - Jesus Garcia-Foncillas
- Translational Oncology Division, Oncohealth Institute, IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain
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