摘要
目的探讨Ⅲ期结直肠癌病人化疗前血清细胞因子水平与术后1年内出现病情复发的关系。方法回顾性选取Ⅲ期结直肠癌术后病人90例,将术后1年内出现肿瘤复发转移或死亡者归为病情复发组(31例),其余归为未复发组(59例)。检测并比较两组病人初次治疗前血清细胞因子干扰素(IFN)α、IFNγ、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1β、IL-2、IL-4、IL-5、IL-6、IL-8、IL-10、IL-12P、IL-17水平以及肿瘤标志物癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原72-4(CA72-4)、糖类抗原242(CA242)、甲胎蛋白(AFP)水平差异。采用Logistic回归分析病人1年内复发独立危险因素,应用受试者工作特征(ROC)曲线分析细胞因子对术后1年内复发的诊断价值。结果复发组IL-1β、IL-5、IL-6、IL-8水平显著高于未复发组,差异有统计学意义(Z=-3.316~-2.113,P<0.05)。ROC曲线分析显示,IL-6相较其他细胞因子诊断价值较高(曲线下面积为0.714,95%置信区间为0.601~0.826,P<0.05)。肿瘤标志物均正常病人47例中,复发组IL-6、TNF-α水平较未复发组高,差异具有统计学意义(Z=-2.365、-2.170,P<0.05);ROC曲线分析结果显示,IL-6、TNF-α相较其他细胞因子诊断价值较高(曲线下面积分别为0.768、0.745,95%置信区间分别为0.608~0.921、0.583~0.953,P<0.05)。多因素分析的结果显示,血清IL-1β水平增高是Ⅲ期结直肠癌病人1年内出现复发转移的独立危险因素(β=-1.506,P<0.05)。结论Ⅲ期结直肠癌术后辅助治疗前的血清IL-6、IL-1β、IL-8、TNF-α水平可作为预测病人术后1年内出现肿瘤复发的辅助指标。
Objective To investigate the association between serum cytokine levels before chemotherapy and recurrence within 1 year after surgery in patients with stageⅢcolorectal cancer.Methods A retrospective analysis was performed for 90 patients with stageⅢcolorectal cancer who underwent surgery,among whom 31 patients with recurrence,metastasis,or death within 1 year after surgery were included as recurrence group,and the remaining 59 patients were included as non-recurrence group.The two groups were compared in terms of the serum levels of cytokines[interferon-α(IFN-α),interferon-γ(IFNγ),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-2,interleukin-4,interleukin-5(IL-5),interleukin-6(IL-6),interleukin-8(IL-8),interleukin-10,interleukin-12P,and interleukin-17]and tumor markers(carcinoembryonic antigen,carbohydrate antigen 199,carbohydrate antigen 72-4,carbohydrate antigen 242,and alpha-fetoprotein)before initial treatment.A Logistic regression analysis was used to investigate the independent risk factors for recurrence within 1 year,and the receiver operating cha-racteristic(ROC)curve was used to analyze the value of cytokines in the diagnosis of recurrence within 1 year after surgery.Results The recurrence group had significantly higher levels of IL-1β,IL-5,IL-6,and IL-8 than the non-recurrence group(Z=-3.316 to-2.113,P<0.05).The ROC curve analysis showed that IL-6 had a significantly higher diagnostic value than the other cytokines,with an area under the ROC curve(AUC)of 0.714(95%CI=0.601-0.826,P<0.05).Among the 47 patients with normal tumor markers,the recurrence group had significantly higher levels of IL-6 and TNF-αthan the non-recurrence group(Z=-2.365,-2.170,P<0.05),and the ROC curve analysis showed that IL-6 and TNF-αhad a significantly higher diagnostic value than the other cytokines(IL-6:AUC=0.768,95%CI=0.608-0.921,P<0.05;TNF-α:AUC=0.745,95%CI=0.583-0.953,P<0.05).The multivariate analysis showed that elevated serum IL-1βlevel was an independent risk factor for recurrence and metastasis within 1 year in patients with stageⅢcolorectal cancer(β=-1.506,P<0.05).Conclusion The serum levels of IL-6,IL-1β,IL-8,and TNF-αbefore postoperative adjuvant therapy for stageⅢcolorectal cancer can be used as auxiliary indices to predict tumor recurrence within 1 year after surgery.
作者
边晓倩
王莎莎
赵淑芬
王赫
孙丽斌
齐卫卫
BIAN Xiaoqian;WANG Shasha;ZHAO Shufen;WANG He;SUN Libin;QI Weiwei(Department of Oncology,The Affiliated Hospital of Qingdao University,Qingdao 266031,China)
出处
《青岛大学学报（医学版）》
CAS
2024年第1期72-76,共5页
Journal of Qingdao University(Medical Sciences)
基金
山东省医药卫生科技发展计划项目(20200-3030451)
北京科创医学发展基金会(KC2021-JX-0186-145)。
关键词
结直肠肿瘤
放化疗
辅助
细胞因子类
预后
colorectal neoplasms
chemoradiotherapy,adjuvant
cytokines
prognosis
