结肠癌患者术前血清中细胞因子的表达对预后的意义

Prognostic Values of Preoperative Cytokines in Serum of Colon Cancer Patients

目的探究Ⅲ期结肠癌患者术前血清中细胞因子,包括表皮生长因子(EGF)、白细胞介素-6(IL-6)和C-反应蛋白(CRP)的表达水平与预后的关系,并评价循环EGF的表达水平与病灶中表皮生长因子受体(EGFR)之间的关系。方法收集经结肠癌根治术的83例Ⅲ期结肠癌患者的临床资料。分析患者术前血清中细胞因子的表达水平与预后的关系。结果 83例患者中,EGF、IL-6和CRP水平的中位数分别为189.4 pg/m L、9.09 pg/m L和1.4 mg/m L。与无病生存率显著相关的因素是术前IL-6水平(P<0.05),而CRP和EGF水平与无病生存率并无显著关系(P>0.05)。血清中EGF的表达水平与肿瘤EGFR阳性以及血清IL-6水平并无显著相关性(P>0.05)。结论检测结肠癌患者术前血清IL-6水平对预后的判断具有重要的价值。

Objective To explore the preoperative serum levels of epidermal growth factor （EGF）, interleukin-6 （IL- 6） ,and C-reactive protein （CRP） in stage Ⅲ colon cancer patients,and the correlation of these cytokines with patients＇ prognosis ; and to evaluate the correlation between serum EGF and EGFR expression in tumor tissues. Methods The clinical data of 83 patients with curatively resected stage Ⅲ colon cancer were collected and analyzed. The correlation between serum cytokine levels and disease status and prognosis were evaluated. Results Among the 83 patients with stage Ⅲ colon cancer,the median levels of EGF ,IL-6 and CRP were 189.4 pg/mL,9.09 pg/mL andl. 4 mg/mL respectively. The factors that were significantly correlated with disease recurrence included lymphovascular invasion （ P 〈 0.01 ）, positive lymph node （ P 〈 0.05 ） and preoperative IL-6 level higher than 9 pg/mL （ P 〈 0.05 ）. No significant difference was found between disease-free survival and serum levels of CRP and EGF （ P 〉 0.05 ）. Multivariate Cox analysis indicated that lymph node status was independent prognostic factor to predict re- currence time （odds ratio 5.03 ;95% confidence interval 1.13 - 23.76;P = 0. 041 ）. No correlations were found between serum EGF level and EGFR expression in tumor tissues or IL-6 level in serum（ P 〉 0.05 ）. Conclusion Preoperative determination of serum IL-6 level in colon cancer patients is valuable to predict prognosis.