Relations of Serum Visfatin and Resistin Levels with Endometrial Cancer and Factors Associated with its Prognosis

  • Published : 2015.06.26


Background: The aims of this study were compare the serum visfatin and resistin levels between endometrial cancer (EC) patients and controls and evaluate their power to predict prognosis. Materials and Methods: This prospective study was conducted between March 2013 to June 2014 on the Gynecologic Oncology Department of the University of Selcuk, Konya, Turkey. A total of 42 EC patients and 42 controls were included and assessed for differences in serum visfatin and resistin levels, along with prognostic factors. Results: Endometrial cancer patients had significantly higher visfatin levels than control s (p: 0.011), associated with deep myometrial invasion (p: 0.019). In contrast the serum level of resistin did not significantly differ between EC patients and controls (p: 0.362). However, high resistin level in EC patients was associated with increase lymph node metastasis (p: 0.009). On logistic regression analysis, we found that serum visfatin elevation was associated with risk of myometrial invasion (OR: 1,091; 95%CI: 1.021-1.166; p: 0.010) and serum resistin with risk of lymph node metastasis (OR: 1.018; 95%CI: 1.000-1.035; p: 0.046). For myometrial invasion prediction, a serum visfatin level greater than 26.8 ng/mL demonstrated a sensitivity and specificity of 66.6 % and 96.4%, respectively. For lymph node metastasis prediction, the best cut-off for serum resistin level was 599ng/mL. A serum resistin level greater than this demonstrated a sensitivity and specificity of 87.5% and 77.1%, respectively. Conclusions: Our data suggest that serum visfatin is elevated in patients with EC and serum visfatin and resistin levels could be used to predict the risk of advance stage lesions.


  1. Acmaz G, Aksoy H, Albayrak E, et al (2014). Evaluation of endometrial precancerous lesions in postmenopausal obese women - a high risk group? Asian Pac J Cancer Prev, 15, 195-8
  2. Alexiou D, Karayiannakis AJ, Syrigos KN, et al (2001). Serum levels of E-selectin. ICAM-1 and VCAM-1 in colorectal cancer patients: correlations with clinicopathological features, patient survival and tumour surgery. Eur J Cancer. 37, 2392-7.
  3. Al-Suhaimi EA, Shehzad A (2013). Leptin, resistin and visfatin: the missing link between endocrine metabolic disorders and immunity. Eur J Med Res, 18, 12.
  4. Amirhakimi A, Karamifar H, Moravej H, Amirhakimi G (2011). Serum resistin level in obese male children. J Obes, 2011, 953410.
  5. Azuma K, Katsukawa F, Oguchi S, et al (2003). Correlation between serum resistin level and adiposity in obese individuals. Obes Res, 11, 997-1001
  6. Bi TQ, Che XM (2010). Nampt/PBEF/visfatin and cancer. Cancer Biol Ther, 10, 119-25.
  7. Braun S, Bitton-Worms K, LeRoith D (2011). The link between the metabolic syndrome and cancer. Int J Biol Sci, 7, 1003-15
  8. Bray F, Ren JS, Masuyer E, Ferlay J (2013). Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer, 132, 1133-45.
  9. Chang YC, Chang TJ, Lee WJ, Chuang LM (2010). The relationship of visfatin/pre-B-cell colony-enhancing factor/nicotinamide phosphoribosyltransferase in adipose tissue with inflammation, insulin resistance, and plasma lipids. Metabolism, 59, 93-9.
  10. Cote ML, Alhajj T, Ruterbusch JJ, et al (2013). Risk factors for endometrial cancer in black and white women: a pooled analysis from the epidemiology of endometrial cancer consortium (E2C2). Cancer Causes Control, 73, 2285
  11. Dalamaga M, Archondakis S, Sotiropoulos G, et al (2012). Could serum visfatin be a potential biomarker for postmenopausal breast cancer? Maturitas, 71, 301-8.
  12. Ferlay J, Soerjomataram I, Dikshit R, et al (2015). Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 136, 359-86.
  13. Fukuhara A, Matsuda M, Nishizawa M, et al (2005). Visfatin: a protein secreted by visceral fat that mimics the effects of insulin. Science, 307, 426-30.
  14. Gallí M, Van Gool F, Rongvaux A, Andris F, Leo O (2010). The nicotinamide phosphoribosyltransferase: a molecular link between metabolism, inflammation, and cancer. Cancer Res, 70, 8-11.
  15. Havrilesky LJ, Cragun JM, Calingaert B, et al (2005). Resection of lymph node metastases influences survival in stage IIIC endometrial cancer. Gynecol Oncol, 99, 689-95.
  16. Hlavna M, Kohut L, Lipkova J, et al (2011). Relationship of resistin levels with endometrial cancer risk. Neoplasma, 58, 124-8.
  17. Howlader N, Noone AM, Krapcho M, et al (2014). SEER cancer statistics review, 1975-2011. Bethesda, MD: National Cancer Institute.
  18. Kim HJ, Lee YS, Won EH et al (2011). Expression of resistin in the prostate and its stimulatory effect on prostate cancer cell proliferation. BJU Int, 108, 77-83.
  19. Kobayashi H, Boelte KC, Lin PC (2007). Endothelial cell adhesion molecules and cancer progression. Curr Med Chem, 14, 377-86.
  20. Kolthur-Seetharam U, Dantzer F, McBurney MW, de Murcia G, Sassone-Corsi P (2006). Control of AIF-mediated cell death by the functional interplay of SIRT1 and PARP-1 in response to DNA damage. Cell Cycle, 5, 873-7.
  21. Kusminski CM, McTernan PG, Kumar S (2005). Role of resistin in obesity, insulin resistance and Type II diabetes. Clin Sci, 109, 243-56.
  22. Linkov F, Burke LE, Komaroff M, et al (2014). An exploratory investigation of links between changes in adipokines and quality of life in individuals undergoing weight loss interventions: possible implications for cancer research. Gynecol Oncol, 133, 67-72.
  23. Luhn P, Dallal CM, Weiss JM, et al (2013). Circulating adipokine levels and endometrial cancer risk in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer Epidemiol Biomarkers Prev, 22, 1304-12.
  24. Moschen AR, Kaser A, Enrich B, et al (2007). Visfatin, an adipocytokine with proinflammatory and immunomodulating properties. J Immunol, 178, 1748-58.
  25. Nakajima TE, Yamada Y, Hamano T, et al (2010). Adipocytokines as new promising markers of colorectal tumors: adiponectin for colorectal adenoma, and resistin and visfatin for colorectal cancer. Cancer Sci, 101, 1286-91.
  26. Nergiz Avcioglu S, Altinkaya SO, Kucuk M, et al (2014). Visfatin concentrations in patients with endometrial cancer. Gynecol Endocrinol, 7, 1-6.
  27. Nohira T, Nagao K, Kameyama K, et al (2004). Identification of an alternative splicing transcript for the resistin gene and distribution of its mRNA in human tissue. Eur J Endocrinol, 151, 151-4.
  28. Parker SL, Tong T, Bolden S, Wingo PA. (1996). Cancer statistics, 1996. CA: A Cancer J Clin, 46, 5-27.
  29. Patel L, Buckels AC, Kinghorn IJ, et al (2003). Resistin is expressed in human macrophages and directly regulated by PPAR gamma activators. Biochem Biophys Res Commun. 300, 472-6.
  30. Pilz S, Mangge H, Obermayer-Pietsch B, Marz W (2007). Visfatin/pre-B-cell colony-enhancing factor: a protein with various suggested functions. J Endocrinol Invest, 30, 138-44.
  31. Rajala MW, Lin Y, Ranalletta M, et al (2002). Cell type-specific expression and coregulation of murine resistin and resistinlike molecule-alpha in adipose tissue. Mol Endocrinol, 16, 1920-30.
  32. Rajamohan SB, Pillai VB, Gupta M, et al (2009). SIRT1 promotes cell survival under stress by deacetylation-dependent deactivation of poly(ADP-ribose). polymerase 1. Mol Cell Biol, 29, 4116-29.
  33. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M (2008). Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet, 371, 569-78
  34. Rzepka R, Dolegowska B, Rajewska A, Kwiatkowski S (2014). On the Significance of New Biochemical Markers for the Diagnosis of Premature Labour. Mediators Inflamm, 2014, 251451.
  35. Secilmis Kerimoglu O, Pekin A, Yilmaz SA, et al (2014). Effect of the percentage of body fat on surgical, clinical and pathological outcomes in women with endometrial cancer. J Obstet Gynaecol Res, 41, 449-55.
  36. Stastny J, Bienertova-Vasku J, Vasku A (2012). Visfatin and its role in obesity development. Diabetes Metab Syndr, 6, 120-4.
  37. Sun G, Bishop J, Khalili S, et al (2007). Serum visfatin concentrations are positively correlated with serum triacylglycerols and down-regulated by overfeeding in healthy young men. Am J Clin Nutr, 85, 399-404.
  38. Tarkowski A, Bjersing J, Shestakov A, Bokarewa MI (2010). Resistin competes with lipopolysaccharide for binding to toll-like receptor 4. J Cell Mol Med, 14, 1419-31
  39. Tian W, Zhu Y, Wang Y, et al (2013). Visfatin, a potential biomarker and prognostic factor for endometrial cancer. Gynecol Oncol, 129, 505-12.
  40. Yang CC, Chang SF, Chao JK et al (2014). Activation of AMPactivated protein kinase attenuates hepatocellular carcinoma cell adhesion stimulated by adipokine resistin. BMC Cancer. 14, 112
  41. Zhu XL, Ai ZH, Wang J, et al (2012). Weighted gene coexpression network analysis in identification of endometrial cancer prognosis markers. Asian Pac J Cancer Prev, 13, 4607-1

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