Plasma Leucine-Rich Alpha-2-Glycoprotein 1 Reflects Higher Histological Grade, Worse Disease-Free Survival, and Unfavorable Overall Survival in Colorectal Cancer Patients who Receive Tumor Resection

Leucine-rich alpha-2-glycoprotein 1 (LRG1) promotes colorectal cancer (CRC) growth, migration, and invasion. This study intended to investigate the association of plasma LRG1 with clinical characteristics, disease-free survival (DFS), and overall survival (OS) in CRC patients who received tumor resection. This study retrospectively included 125 CRC patients who received tumor resection. LGR1 level was detected in their preoperative plasma samples via enzyme-linked immunosorbent assay. The median level of plasma LRG1 was 53.4 μg/mL (quartile 1: 34.0 μg/mL, quartile 3: 102.5 μg/mL). Plasma LRG1 was elevated in patients with high histological grade versus those with low grade (P = 0.005). Plasma LRG1 was varied among patients with different node (P = 0.004) and tumor-node-metastasis (P = 0.001) stages. Moreover, plasma LRG1 ≥ 50 μg/mL (at around the median level) was not related to DFS (P = 0.074) or OS (P = 0.077). While plasma LRG1 ≥ 100 μg/mL (at around the quartile 3 level) was linked with shortened DFS (P = 0.018) and OS (P = 0.016). The 3-year accumulating DFS and OS rates were 60.8% and 64.4% in patients with plasma LRG1 ≥ 100 μg/mL; they were 75.7% and 82.9% in patients with plasma LRG1 < 100μg/mL, respectively. Furthermore, plasma LRG1 ≥ 100 μg/mL (hazard ratio (HR): 2.728, P = 0.036) and age ≥ 60 years (HR: 2.815, P = 0.041) were independently associated with shortened DFS. Only node stage (HR: 3.150, P = 0.004) was independently linked with shortened OS. In conclusion, LRG1 is associated with elevated histological grade and worse DFS and OS, with its level ≥ 100 μg/mL as an independent factor for shortened DFS in CRC patients who receive tumor resection.