Correlation Between Serum Levels of Tumor Necrosis Factor-Alpha (TNF-Α) And Histopathological Grading of Colorectal Cancer

Abstract

Background: Colorectal cancer is one of the most common malignancies in the world and the fourth leading cause of cancer death. Inflammation of long-term duration continues to be the disease’s initiating and progressing factor, as tumor necrosis factor-alpha and several cytokines are regulators of its growth. This factor has been shown to stimulate the growth of sarcoma cells, angiogenes growth, and metastasizes the ROS-producing system to stimulate sarcoma cells. The connections among the growth of TNF-α and histopathological grading in colorectal tumors were not calculated. The purpose of the study: to assess the serum level of TNF-α in patients with colorectal sarcoma compared to a control group and to determine the relationship between TNF-α amounts in the tissues and histopathological benignant sarcoma grading.

Materials and methods: We have conducted a case–control survey in Middle Euphrates Oncology Center, Najaf, Iraq, from December 2023 through April 2024. This study enrolled 62 individuals whose first diagnosis was histopathological verification of colorectal sarcoma and 48 age- and sex-matched healthy people. Furthermore, people with chronic systemic diseases, autoimmune illnesses, or other malignant tumors were removed from the test. Venous blood samples have been gathered before the launch of any chemotherapy or radiotherapy. A human ELISA kit has examined the TNF-α content in the serum, according to the manufacturer’s instruction.

Results: Mean serum TNF-α levels were significantly higher in CRC patients (42.6 ± 11.3 pg/mL) than in controls (35.8 ± 9.7 pg/mL) (p = 0.034). Furthermore, TNF-α concentrations demonstrated a significant stepwise increase with tumor dedifferentiation: Grade I (37.8 ± 8.4 pg/mL), Grade II (43.9 ± 10.2 pg/mL), and Grade III (49.6 ± 11.1 pg/mL), with the intergroup difference reaching statistical significance (p = 0.022). These findings indicate a positive correlation between TNF-α expression and histopathological severity in colorectal cancer.

Conclusion: Elevated levels of TNF-α have been implicated with the presence and histological advancement of CRC. With rising tumor dedifferentiation, TNF-α broadens, which could be associated with a rise in inflammatory and oncogenic signaling in the worst CRC phenotypes. Hence, TNF-α stands as a potential biomarker of tumor grade and therapeutic monitoring, highlighting its role in the pathogenesis of CRC.

Keywords:

TNF-α, periodontitis, Colorectal Cancer, Histopathological Grades

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