Alteration of hypothalamus-pituitary-adrenal glands axis in colorectal cancer patients. Preliminary report

S. Crippa, C. Mussi, C. Angelini, R. Caprotti, C. Bonardi, P. Muselli, M. Scotti, G. Piacentini, F. Uggeri

Research output: Contribution to journalArticlepeer-review


Aim. In advanced cancer patients a cell-mediated immunological impairment, both at base-line and during postoperative period, is often found and is associated with poor prognosis. Cortisol is strictly involved in the response to major surgical stress, is an immunosuppressor and causes a redistribution of immunological population cells in different tissues. The aim of the study was to verify serum levels and circadian rhythm of cortisol in patients with colorectal cancer at baseline before surgery and in the postoperative period, and relate it to the immune status. Methods. In 21 patients with colorectal cancer undergoing surgery we evaluated the assessment of total lymphocytes, CD4+, cortisolemy, circadian rhythm of cortisol (11 p.m. and 8 a.m.) at baseline and in 3rd and 7th postoperative days. Results. Increase of cortisolemy, as decrease of total and CD4+ lymphocytes in the postoperative period versus baseline was statistically significant. Patients with an altered circadian rhythm were 47% and 36% at 3rd and 7 th postoperative days, respectively. At baseline 19% of patients had an altered cortisol circadian rhythm and it was more frequent in patients with nodal involvement (p

Original languageEnglish
Pages (from-to)581-585
Number of pages5
JournalMinerva Chirurgica
Issue number4
Publication statusPublished - Aug 2003


  • Colonic neoplasms, immunology
  • Cortisol
  • Interleukin-2

ASJC Scopus subject areas

  • Surgery


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