晚期卵巢浆液性腺癌患者术前血清细胞因子水平与预后的关系

Clinicopathologic and prognostic significance of serum levels of cytokines in patients with advanced serous ovarian cancer prior to surgery

目的 探讨晚期卵巢浆液性腺癌患者术前血清中6种细胞因子水平与临床病理因素及预后的关系.方法 用流式细胞微球阵列术检测51例晚期卵巢癌患者及46例健康女性（对照组）血清中干扰素-γ（IFN-γ）、肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-2、IL-4、IL-5、IL-10的表达水平.结果 卵巢癌患者IFN-γ（20.68±11.45）、IL-2（4.54±1.18）、IL-4（5.66±2.25）、IL-5（2.72±0.86）μg/L及IL-10（5.93±7.92）μg/L高于对照组,差异有统计学意义（P＜0.01或P＜0.05）;而TNF-α（7.53±8.47）低于对照组,差异有统计学意义（P＜0.01）;卵巢癌患者的IFN-γ/IL-4比值（3.93±2.34）低于对照组,差异有统计学意义（P＜0.01）.Kaplan-Meier生存分析结果表明年龄（P=0.016）、绝经状态（P=0.001）、IL-10水平（P=0.010）与患者生存状态明显相关;Cox回归分析显示,IL-2（P=0.045）和IL-10（P=0.007）是影响预后的独立因素,不受其他细胞因子以及临床参数诸如临床分期、分化程度、年龄、是否淋巴结转移、体质量指数、是否绝经、发病部位等的影响.结论 晚期卵巢癌患者机体出现辅助性T细胞（Th）1/Th2失衡和不同程度的免疫机制紊乱.年龄和绝经状态是影响患者生存的重要因素,IL-2和IL-10水平是卵巢癌的独立预后因素.

Objective To study the clinicopathologic and prognostic significance of serum levels of six cytokines （IFN-γ, TNF-α, IL-10, IL-5, IL-4, IL-2） in patients with advanced serous ovarian cancer prior to surgery. Methods The serum levels of six cytokines were detected in 51 patients with advanced serous ovarian cancer and 46 healthy controls, using cytometric bead arrays. Results The serum levels of IFN-γ （20.68 ± 11.45）, IL-2 （4.54 ± 1.18）, IL-4 （5.66 ±2.25）, IL-5 （2.72 ±0.86） μg/L and IL-10 （5.93 ±7.92） μg/L were higher （P＜0.01, P＜0.05） and the serum level of TNF-α（7.53 ±8.47） was lower （P ＜ 0.01 ） in patients with advanced serous ovarian cancer than those in the healthy controls. The IFN-γ/IL-4 ratio （3.93 ±2.34） of the patients was lower than that of the controls （ P ＜ 0.01 ）. KaplanMeier analysis revealed that patient＇s age （P =0.016）, menopausal status （P = 0.001 ） and serum IL-10 level （P = 0.010） correlated significantly with patient＇s survival. Cox regression analysis showed that serum IL-2 （ P = 0.045 ） and IL-10 levels （ P = 0.007 ） were the independent prognostic factors. Conclusions Patients with advanced serous ovarian cancer have Th1/Th2 imbalance and immune function disturbance.The age of patients and menopausal status are important prognostic factors. IL-2 and IL-10 level are also independent predictors of survival.