Serum CHI3L1 and FABP1 levels in relation to tumor differentiation in colonic adenocarcinoma

Background: Colonic adenocarcinoma remains one of the most common gastrointestinal malignancies. Accurate grading of tumor differentiation is essential for prognosis and treatment planning. Blood-based biomarkers that reflect tumor behavior may offer useful tools for patient assessment. Aim: This study examined the relationship between serum levels of CHI3L1 (YKL-40) and FABP1 and the histopathological differentiation of colonic adenocarcinoma. Methods: An observational study was conducted on 100 patients with histologically confirmed colonic adenocarcinoma. Tumor differentiation was classified as well, moderately, or poorly differentiated. Blood samples were analyzed for CHI3L1 and FABP1 levels using standard biochemical assays. Statistical comparisons were made using ANOVA, Kaplan-Meier survival analysis, and logistic regression. Results: Patients with poorly differentiated tumors had significantly higher mean serum levels of CHI3L1 (85.4±11.2 ng/mL) and FABP1 (69.7±7.9 ng/mL) compared to those with moderately (CHI3L1: 65.3±9.5 ng/mL; FABP1: 49.8±6.8 ng/mL) and well-differentiated tumors (CHI3L1: 50.1±7.8 ng/mL; FABP1: 34.6±5.9 ng/mL). The differences were statistically significant (p < 0.001). Poorly differentiated tumors also correlated with more advanced stage (Stage III/IV), higher rates of weight loss and anemia, and reduced overall survival. Kaplan-Meier analysis showed a median survival of 18 months in the poorly differentiated group, compared to 30 and 45 months in the moderately and well-differentiated groups, respectively. Conclusion: These blood-based markers may help identify patients with more aggressive disease and support clinical decision-making.