胃癌患者血清IL-18、IL-1β水平变化及其临床意义

Serum Levels and Clinical Significance of IL-18 and IL-1β in Patients with Gastric Cancer

背景:慢性炎症与胃癌的发生、发展密切相关,炎症相关细胞因子白细胞介素-18(IL-18)、IL-1β通过多种机制参与了胃癌的发生、发展过程。目的:检测不同胃黏膜病变患者的血清IL-18、IL-1β水平,初步探讨两者在胃癌中的作用和临床意义。方法:采用ELISA法检测324例胃癌、40例慢性非萎缩性胃炎(CNAG)、13例慢性萎缩性胃炎伴或不伴肠上皮化生(CAG/IM)、20例轻-中度异型增生患者的血清IL-18、IL-1β水平,胃癌患者同时检测幽门螺杆菌(Hp)-IgG抗体。分析血清IL-18、IL-1β水平与胃癌患者临床病理参数和Hp感染状态的关系,以ROC曲线评估两者对胃癌的诊断效能。结果:从CNAG、CAG/IM、异型增生至胃癌,血清IL-18、IL-1β水平逐渐升高,除CNAG与CAG/IM组间IL-1β水平外,任意两组间差异均有统计学意义(P<0.05)。肿瘤直径≥5 cm、有淋巴结或远处转移、肿瘤浸润深度T3、T4、TNM分期Ⅲ、Ⅳ期和Hp感染阳性的胃癌患者,血清IL-18、IL-1β水平显著升高(P<0.05)。血清IL-18、IL-1β联合检测诊断胃癌的ROC曲线下面积(AUC)大于单项检测(0.867对0.837和0.795)。结论:血清IL-18、IL-1β水平在胃癌演进过程中呈动态升高趋势,且与胃癌生长、浸润、转移密切相关。两者联合检测对胃癌有较高的诊断价值,并可能有助于胃癌病情评估和预后判断。

Background： Chronic inflammation is closely associated with occurrence and development of gastric cancer,and inflammatory cytokines,interleukin-18（IL-18） and IL-1β are involved via a variety of mechanisms.Aims： To determine the serum levels of IL-18 and IL-1β in patients with different gastric mucosal lesions and to explore the role of these two cytokines in gastric cancer and their clinical significance.Methods： Serum levels of IL-18 and IL-1β were detected by ELISA in patients with different gastric mucosal lesions,including 324 gastric cancer,40 chronic non-atrophic gastritis（CNAG）,13 chronic atrophic gastritis with or without intestinal metaplasia（CAG/IM） and 20 mild to moderate dysplasia.Helicobacter pylori（Hp） IgG antibody was detected in patients with gastric cancer.Correlations of serum levels of IL-18 and IL-1β with clinicopathological parameters and Hp infection were analyzed in patients with gastric cancer.ROC curve was used to assess the performance of serum IL-18 and IL-1β for diagnosis of gastric cancer.Results： Serum levels of IL-18 and IL-1β increased gradually from CNAG,CAG/IM,dysplasia to gastric cancer;except for IL-1β between CNAG and CAG/IM groups,significant differences were found between any two groups（P〈0.05）.In gastric cancer group,they were positively correlated with tumor size,lymph node and distant metastases,depth of invasion,TNM stage and Hp infection（P〈0.05）.Area under the ROC curve（AUC） of combined detection of serum IL-18 and IL-1β for diagnosis of gastric cancer was superior to that of IL-18 or IL-1β detection alone（0.867 vs.0.837 and 0.795）.Conclusions： Serum levels of IL-18 and IL-1β increase dynamically with the tumorigenesis of gastric cancer,and are closely related to growth,invasiveness and metastasis of gastric cancer.Combined detection of serum IL-18 and IL-1β might be used as a biomarker for diagnosis and tumor progression and prognosis assessment of gastric cancer.