晚期乳腺癌患者经TP方案治疗后TNF-α、IL-6和IL-2水平变化及对预后的预测价值

Changes of TNF-α,IL-6 and IL-2 levels and their prognostic predictive value for prognosis in patients with advanced breast cancer after treated with the TP regimen

目的 分析晚期乳腺癌患者经TP方案治疗后肿瘤细胞坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-2(IL-2)水平变化及对预后的预测价值。方法 收集2017年10月至2020年8月武汉大学中南医院收治的86例晚期乳腺癌患者的临床资料(研究组),另选取同期55名行健康体检者作为对照组。比较对照组及研究组化疗前后TNF-α、IL-6、IL-2水平变化情况;对研究组进行1年随访,观察患者预后情况,将患者分为预后良好组和预后不良组,比较两组TNF-α、IL-6、IL-2水平;绘制受试者工作特征曲线(ROC),分析上述因子对乳腺癌患者预后的预测价值。结果 TNF-α、IL-6水平:研究组治疗前>治疗后>对照组;IL-2水平:研究组治疗前<治疗后<对照组,差异均有统计学意义(P<0.05)。经随访,预后不良者17例(19.77%,预后不良组),预后良好者69例(80.23%,预后良好组),治疗后,两组TNF-α、IL-6水平均较治疗前下降,且预后良好组TNF-α、IL-6水平低于预后不良组,IL-2水平较治疗前增高,且预后良好组IL-2水平高于预后不良组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,三者联合检测的曲线下面积(AUC)、敏感度、特异度分别为0.822、0.899、0.922,均明显高于单一检测(P<0.05)。结论 TNF-α、IL-6、IL-2在晚期乳腺癌患者中呈异常表达,可作为评估化疗治疗疗效及预测患者预后的有效辅助指标。

Objective To analyze the changes of tumor cell necrosis factor-α(TNF-α),Interleukin-6(IL-6)and Interleukin-2(IL-2)levels and its prognostic prediction in patients with advanced breast cancer after treated with the TP regimen. Methods The clinical data of 86 patients with advanced breast cancer admitted to Zhongnan Hospital of Wuhan University from October 2017 to August 2020 were collected(research group),another 55 healthy subjects who had physical examination during the same period were selected as the control group. The changes in the levels of TNF-α,IL-6,and IL-2 in the two groups before and after chemotherapy for breast cancer were compared;the study group was followed up for 1 year to observe the prognosis of the patients,and the patients were divided into a good prognosis group and a poor prognosis group,and the levels of TNF-α,IL-6,and IL-2 in the two groups were compared. The receiver operating characteristic curve(ROC)was drawn to analyze the value of the above factors in predicting the prognosis of patients with breast cancer. Results The levels of TNF-α and IL-6:before treatment in the study group > after treatment in the study group > the control group;IL-2 level:before treatment in the study group < after treatment < the control group,the difference was statistically significant(P<0.05). After follow-up,17 cases had a poor prognosis(19.77%,poor prognosis group),and 69 cases had a good prognosis(80.23%,good prognosis group),after treatment,the levels of TNF-α and IL-6 in the two groups were decreased compared with those before treatment,and the levels of IL-2 were increased compared with those before treatment,and the levels of TNF-α and IL-6 in the good prognosis group were lower than those in the poor prognosis group,and the IL-2 level was higher than that in the poor prognosis group,and the difference was statistically significant(P<0.05). The results of ROC curve analysis showed that the area under curve(AUC),sensitivity,and specificity of the three combined detections were 0.822,0.899 and 0.922,respectively,which were significantly higher than those of a single detection(P<0.05). Conclusion TNF-α,IL-6,and IL-2 are abnormally expressed in patients with advanced breast cancer,which can be used as effective auxiliary indicators to evaluate the efficacy of chemotherapy and predict the prognosis of patients.