Korean J Health Promot.  2017 Dec;17(4):282-288. 10.15384/kjhp.2017.17.4.282.

Prognostic Role of Serum Vitamin B₁₂ in Solid Tumor Patients

• Oh HK
• Lee JY
• Yoon SW
• Eo WK
• Han SN

• KMID: 2399339
• DOI: http://doi.org/10.15384/kjhp.2017.17.4.282

Abstract

BACKGROUND
Serum vitamin B₁₂ has been suggested as one of the cancer diagnostic markers and predictors for survival in cancer patients. In this study, we investigated the relationship between vitamin B₁₂ and tumor progression.
METHODS
Solid tumor patients who had serum vitamin B₁₂ levels and radiologic test follow-up were included in the study. A total of 55 patients were included. Receiver operating characteristic analysis was performed to determine the cut-off value of vitamin B₁₂ for tumor progression. Kaplan-Meier method and Cox proportional hazard model for time to progression (TTP) were performed. Subgroup analysis was performed on patients with or without liver lesion (hepatocellular carcinoma and liver metastasis).
RESULTS
The cut-off value of vitamin B₁₂ for tumor progression prediction was 691.4 pg/mL, the sensitivity was 57.1% and the specificity was 59.3%. Patients with vitamin B₁₂≥691.4 pg/mL had shorter median TTP (2.1 months vs. 3.4 months, P=0.011). In subgroup analysis of patients without liver lesion, median TTP was significantly shorter in patients with vitamin B₁₂≥691.4 pg/mL (1.6 months vs. 6.3 months, P=0.021), while there was no significant difference in TTP among the patients with liver lesion. Higher vitamin B₁₂ level (≥691.4 pg/mL) was an independent prognostic factor for tumor progression (adjusted hazard ratio 2.4, 95% confidence interval 1.2-4.8, P=0.019).
CONCLUSIONS
Serum vitamin B₁₂ level can be used as a predictor of tumor progression in patients with solid tumors especially in patients without liver lesion. Additional large scale prospective studies are required to confirm this.

Keyword

Vitamin B₁₂; Biomarkers; Neoplasms; Disease progression

MeSH Terms

Biomarkers
Disease Progression
Follow-Up Studies
Humans
Liver
Methods
Proportional Hazards Models
Prospective Studies
ROC Curve
Sensitivity and Specificity
Vitamins*
Biomarkers
Vitamins

Figure

• 

  Figure 1 Progression receiver operating characteristic curve for vitamin B12. 691.4 pg/mL was the cut-off value for serum vitamin B12 level related with tumor progression.

• 

  Figure 2 Kaplan-Meier curve for time to progression (TTP). (A) All patients. Median TTP in patients with vitamin B12<691.4 pg/mL and in patients with vitamin B12≥691.4 pg/mL was 3.4 months (95% confidence interval [CI] 1.8–5.0) and 2.1 months (1.9–2.3), respectively (P=0.011). (B) Non-liver lesiona group. Median TTP in patients with vitamin B12<691.4 pg/mL and in patients with vitamin B12≥691.4 pg/mL was 6.3 months (2.9–9.7) and 1.6 months (0.0–3.5), respectively (P=0.021). (C) Liver lesion group. Median TTP in patients with vitamin B12<691.4 pg/mL and in patients with vitamin B12≥691.4 pg/mL was 1.8 months (1.0–2.6) and 2.1 months (2.0–2.3), respectively (P=0.816). P values by log-rank test. aLiver lesion included hepatocellular carcinoma and liver metastasis.

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