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.
Abstract
Objective To investigate the association between serum cytokine levels before chemotherapy and recurrence within 1 year after surgery in patients with stage Ⅲ colorectal cancer.Methods A retrospective analysis was performed for 90 patients with stage Ⅲ colorectal 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 nec-rosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-2,interleukin-4,interleukin-5(IL-5),interleukin-6(IL-6),interleu-kin-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 re-gression 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.Re-sults 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-α than the non-recurrence group(Z=-2.365,-2.170,P＜0.05),and the ROC curve analysis showed that IL-6 and TNF-a had 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-1p level was an independent risk factor for recurrence and metastasis within 1 year in patients with stage Ⅲ colorectal cancer(β=-1.506,P＜0.05).Conclusion The serum levels of IL-6,IL-1β,IL-8,and TNF-α before postoperative adjuvant therapy for stage m colorectal cancer can be used as auxiliary indices to predict tumor recurrence within 1 year after surgery.
基金项目
山东省医药卫生科技发展计划(20200-3030451)
北京科创医学发展基金会项目(KC2021-JX-0186-145)
维普
万方数据