Open Access Highly Accessed Research article

Serum concentration of alpha-1 antitrypsin is significantly higher in colorectal cancer patients than in healthy controls

Sergio Pérez-Holanda1*, Ignacio Blanco2, Manuel Menéndez3 and Luis Rodrigo4

Author Affiliations

1 General Surgery Department, Hospital Valle del Nalón, 33920 Langreo, Principality of Asturias, Spain

2 Board of Directors of the Alpha1-Antitrypsin Deficiency Spanish Registry, Spanish Society of Pneumology (SEPAR), Spanish Lung Foundation Breathe, Provenza, 108, 08029 Barcelona, Spain

3 Clinical Biochemistry Department, Instituto Nacional de Silicosis, Hospital Universitario Central de Asturias, 33006 Oviedo, Principality of Asturias, Spain

4 Department of Gastroenterology, Hospital Universitario Central de Asturias, 33006 Oviedo, Principality of Asturias, Spain

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BMC Cancer 2014, 14:355  doi:10.1186/1471-2407-14-355

Published: 21 May 2014



The association between alpha-1 antitrypsin (AAT) deficiency and colorectal cancer (CRC) is currently controversial. The present study compares AAT serum concentrations and gene frequencies between a group of CRC patients and a control group of healthy unrelated people (HUP).


267 CRC subjects (63% males, 72 ± 10 years old) were enlisted from a Hospital Clinic setting in Asturias, Spain. The HUP group comprised 327 subjects (67% males, mean age 70 ± 7.5 years old) from the same geographical region. Outcome measures were AAT serum concentrations measured by nephelometry, and AAT phenotyping characterization by isoelectric focusing.


Significantly higher serum concentrations were found among CRC (208 ± 60) than in HUP individuals (144 ± 20.5) (p = 0.0001). No differences were found in the phenotypic distribution of the Pi*S and Pi*Z allelic frequencies (p = 0.639), although the frequency of Pi*Z was higher in CRC (21%) than in HUP subjects (15%).


The only statistically significant finding in this study was the markedly higher AAT serum concentrations found in CRC subjects compared with HUP controls, irrespective of whether their Pi* phenotype was normal (Pi*MM) or deficient (Pi*MS, Pi*MZ and Pi*SZ). Although there was a trend towards the more deficient Pi* phenotype the more advanced the tumor, the results were inconclusive due to the small sample size. Consequently, more powerful studies are needed to reach firmer conclusions on this matter.

Alpha-1 antitrypsin; Serum concentration; Gene frequency; Colorectal cancer