Perspectives of using the extracellular neutrophil trap levels in colorectal cancer: A literature review

Abstract

Relevance: This literature review evaluates an alternative type of neutrophil immune response – the ability for NETosis or forming neutrophil extracellular traps (NETs). NETs influence the processes of carcinogenesis and cancer metastasis and play a role in the formation of tumor microenvironment and tumor-associated inflammation. The study of netosis has provided a deeper understanding of the mechanisms of intercellular interactions of the tumor microenvironment. NETs can also potentially become prognostic markers and predictors of complications of antitumor treatment of various cancers, including colorectal cancer (CRC).

The study aimed to summarize and systematize the current information on NETs and the impact of this phenomenon on the course of CRC and metastasis, as well as identify potential clinical points for using this marker in oncological practice.

Methods: The articles were searched and selected in Pubmed, Web of Science, Scopus, and RSCI databases by keywords among articles published in the past 10 years.

Results: NETs play an important role in the immune response to tumor niches and the metastasis of various solid tumors. There are data on the possibility of using NETs as a prognostic marker in various oncologic diseases. Experimental and clinical studies showed a potential relationship between NET levels and chemotherapy resistance and the impact of chemotherapy on the incidence of various complications. Chemotherapy with 5-Fluorouracil, according to the results of experimental studies, significantly increases the formation of NETs. The influence on the mechanism of NET release showed limited clinical efficacy of chemotherapy in CRC patients with PIK3CA mutation.

The phenomenon of NETs is still poorly understood, and more studies are needed to widely implement this indicator into routine practice; however, research in this direction has the potential to have broad prospects for clinical application.

Conclusion: Advances in immunology and the discovery of the netosis process have led to a deeper understanding of the mechanisms of interactions in the tumor microenvironment. Studying this process may make it possible to control or predict cancer progression and complications of antitumor treatment.