Effects of exercise on inflammation, circulating tumor cells, and circulating tumor DNA in colorectal cancer.

IF 9.7 1区医学 Q1 HOSPITALITY, LEISURE, SPORT & TOURISM

Journal of Sport and Health Science Pub Date : 2025-03-17 DOI:10.1016/j.jshs.2025.101036

Justin C Brown, Stephanie L E Compton, Andrew Kang, Anjana Jayaraman, L Anne Gilmore, Brian J Kirby, Frank L Greenway, Shengping Yang, Guillaume Spielmann

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引用次数: 0

Abstract

Background: The biological mechanisms by which postdiagnosis physical activity improves disease-free survival in colorectal cancer survivors remain incompletely understood. This trial tested the hypothesis that 12 wk of moderate-intensity aerobic exercise, when compared with a control group, would change inflammation, CTCs, and ctDNA in a manner consistent with an improved cancer prognosis.

Methods: This trial randomized Stages I-III colorectal cancer survivors to 12 wk of home-based moderate-intensity aerobic exercise or a waitlist control group. The co-primary endpoints were high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6), secondary endpoints were soluble tumor necrosis factor-α receptor 2 (sTNFαR2) and circulating tumor cells (CTCs), and the exploratory endpoint was tumor fraction quantified from circulating tumor DNA.

Results: Sixty subjects were randomized (age = 60.6 ± 10.8 years, mean ± SD; 39 (65%) females; 46 (77%) colonic primary tumor), and 59 (98%) subjects completed the study. Over 12 wk, exercise adherence was 92% (95% confidence interval (95%CI): 86‒99). Exercise improved submaximal fitness capacity (0.36 metabolic equivalents; 95%CI: 0.05‒0.67; p = 0.025) and objectively measured moderate-to-vigorous-intensity physical activity (34.8%, 95%CI: 11.3‒63.1; p = 0.002) compared to control. Exercise did not change hs-CRP (20.9%, 95%CI: -17.1 to 76.2; p = 0.32), IL-6 (11.4%, 95%CI: -7.5 to 34.0; p = 0.25), or sTNFαR2 (-3.6%, 95%CI: -13.7 to 7.7; p = 0.52) compared to control. In the subgroup of subjects with elevated baseline hs-CRP (n = 35, 58.3%), aerobic exercise reduced hs-CRP (-35.5%, 95%CI: -55.3 to -3.8; p = 0.031). Exercise did not change CTCs (0.59 cells/mL, 95%CI: -0.33 to 1.51; p = 0.21) or tumor fraction (0.0005, 95%CI: -0.0024 to 0.0034; p = 0.73). In exploratory analyses, higher aerobic exercise adherence correlated with a reduction in CTCs (ρ = -0.37, 95%CI: -0.66 to -0.08; p = 0.013).

Conclusion: Colorectal cancer survivors achieved high adherence to a home-based moderate-intensity aerobic exercise prescription that improved fitness capacity and physical activity but did not reduce inflammation or change tumor endpoints from a liquid biopsy.

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运动对结直肠癌炎症、循环肿瘤细胞和循环肿瘤DNA的影响。

背景：诊断后体育活动提高结直肠癌幸存者无病生存的生物学机制尚不完全清楚。该试验验证了一个假设，即与对照组相比，12周的中等强度有氧运动将以与改善癌症预后一致的方式改变炎症、ctc和ctDNA。方法：该试验将I-III期结直肠癌幸存者随机分为12周的家庭中等强度有氧运动组或候补对照组。共同主要终点为高敏c反应蛋白（hs-CRP）和白细胞介素-6 (IL-6)，次要终点为可溶性肿瘤坏死因子-α受体2 （sTNFαR2）和循环肿瘤细胞（ctc），探索终点为循环肿瘤DNA量化的肿瘤分数。结果：60例受试者随机化(年龄 = 60.6±10.8岁，mean±SD；女性39人（65%）；46例（77%）结肠原发肿瘤患者，59例（98%）完成了研究。在12周内，运动依从性为92%（95%置信区间（95% ci）： 86-99）。运动提高了亚极限适应能力(0.36代谢当量；95%置信区间:0.05—-0.67;p = 0.025)和客观测量的中高强度体育活动(34.8%,95%CI: 11.3-63.1；P = 0.002)。运动没有改变hs-CRP (20.9%, 95%CI: -17.1至76.2；p = 0.32),IL-6 (11.4%, 95%CI: -7.5 ~ 34.0； = 0.25页),或者sTNFαR2(-3.6%, 95%置信区间ci: -13.7 - 7.7;P = 0.52)。在基线hs-CRP升高的受试者亚组中（n = 35,58.3%），有氧运动降低hs-CRP (-35.5%, 95%CI: -55.3至-3.8； = 0.031页)。运动没有改变ctc(0.59个细胞/mL， 95%CI: -0.33 ~ 1.51；p = 0.21)或肿瘤分数(0.0005,95%CI: -0.0024 ~ 0.0034； = 0.73页)。在探索性分析中，较高的有氧运动依从性与ctc的降低相关(ρ = -0.37,95%CI: -0.66至-0.08； = 0.013页)。结论：结直肠癌幸存者获得了基于家庭的中等强度有氧运动处方的高依从性，提高了健身能力和身体活动，但没有减少炎症或改变液体活检的肿瘤终点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Sport and Health Science SPORT SCIENCES-

CiteScore

18.30

自引率

1.70%

发文量

101

审稿时长

22 weeks

期刊介绍： The Journal of Sport and Health Science (JSHS) is an international, multidisciplinary journal that aims to advance the fields of sport, exercise, physical activity, and health sciences. Published by Elsevier B.V. on behalf of Shanghai University of Sport, JSHS is dedicated to promoting original and impactful research, as well as topical reviews, editorials, opinions, and commentary papers. With a focus on physical and mental health, injury and disease prevention, traditional Chinese exercise, and human performance, JSHS offers a platform for scholars and researchers to share their findings and contribute to the advancement of these fields. Our journal is peer-reviewed, ensuring that all published works meet the highest academic standards. Supported by a carefully selected international editorial board, JSHS upholds impeccable integrity and provides an efficient publication platform. We invite submissions from scholars and researchers worldwide, and we are committed to disseminating insightful and influential research in the field of sport and health science.