The potential role of tissue zonulin levels as diagnostic biomarkers in colon adenocarcinomas

Distinguishing between benign and malignant masses during endoscopic examination of colon masses is critical; however, predictive parameters other than lesion appearance are lacking. This study aimed to compare the zonulin levels in colorectal cancer tissues with those in normal colon tissues to ascertain their diagnostic value. Our study included 108 patients in the study group whose colonoscopy revealed a mass in the colon and whose biopsy revealed adenocarcinoma, and 60 healthy individuals in the control group with normal colonoscopy findings. Three samples were collected: 1 cancerous tissue, 1 healthy tissue (approximately 10-15 cm from the cancerous tissue in the study group), and 1 healthy colon tissue in the control group. These samples were stored at -80°C and their zonulin levels were compared to determine their correlation with clinical variables. The sample size was calculated with a 95% confidence interval and 80% power. As a result of this calculation, 108 patients and 60 control group participants were identified. Control group selection criteria were determined as follows: Healthy individuals matched to the study group in terms of age and gender. The median zonulin levels in the study group were 60.98 ng/mL in cancerous tissues, 27.98 ng/mL in noncancerous tissues, and 15.80 ng/mL in the control group. Zonulin levels in cancerous tissues were significantly higher than those in healthy tissues (60.98 vs 27.98, respectively, P < .001) and control tissues (60.98 vs 15.80, respectively, P < .001). Significantly higher zonulin levels were noted in both healthy and tumor tissues of female patients than in those of male patients (30.30 vs 22.45, P < .001 and 63.17 vs 49.36, P = .009, respectively). The median zonulin level in colorectal adenocarcinoma tissues was significantly higher than that in the healthy colon tissues of the control group and normal colon tissues of patients with cancer. If corroborated by future studies, zonulin levels may serve as a potential predictive marker with diagnostic value.