Nucleosome assembly protein 1-like 1 (NAP1L1) in colon cancer patients: a potential biomarker with diagnostic and prognostic utility

OBJECTIVE To evaluate the diagnostic and prognostic utility of nucleosome assembly protein 1-like 1 (NAP1L1) in colon cancer patients. PATIENTS AND METHODS A total of 95 patients with colon cancer [mean (SD) age: 61.0 (1.7) years, 58.9% were males] and 50 healthy individuals [mean (SD) age: 61.0 (2.3) years, 52.0% were males] were included in this prospective multicenter study. Data on patient demographics (age, gender) and serum NAP1L1 levels were recorded in both control and colon cancer groups. In colon cancer patients, serum NAP1L1 levels were further analyzed with respect to TNM stages and tumor size. RESULTS Serum NAP1L1 levels were significantly higher in colon cancer patients as compared with control subjects [median (min-max) 14(12-16) vs. 2(1-2) ng/mL, p 4 cm vs. <4 cm [15(12-16) vs. 12(12-14) ng/mL), p<0.001] and for M1 vs. M0 stage [15(12-16) vs. 12(12-14) ng/mL), p<0.001]. Serum NAP1L1 levels were significantly higher in T4 stage tumors vs. T1, T2 and T3 stage tumors (p<0.001 for each), in T3 stage tumors vs. T1 and T2 stage tumors (p<0.001 for each) and in N2 stage tumors vs. N0 and N1 stage tumors (p<0.001 for each). CONCLUSIONS Our findings revealed for the first time the substantial rise in serum NAP1L1 levels among colon cancer patients as compared to controls and as correlated with the disease progression. Accordingly, NAP1L1 seems to be a potential biomarker for colon cancer, offering clinically important information on early diagnosis and risk stratification.