血清白细胞介素-23水平对转移性前列腺癌进展的预测研究

The value of serum IL-23 levels in predicting the progression of metastatic prostate cancer

目的探讨应用血清白介素(IL)-23对不同治疗阶段前列腺癌进展的预测价值。方法收集2018年6月至2019年3月北京医院门诊及住院确诊的转移性前列腺癌患者共124例,根据欧洲泌尿外科前列腺癌指南TNM分期标准对确诊患者进行分期,并分别检测转移性去势抵抗型前列腺癌(mCRPC)组、转移性去势敏感型前列腺癌(mCSPC)组、良性前列腺增生组患者的血清IL-23水平,并对mCSPC患者根据病情是否稳定分组,两组患者血清IL-23水平进行亚组分析,各组患者IL-23水平均结合患者的Gleason评分、前列腺特异性抗原(PSA)水平进行分析比较。结果mCRPC组患者血清IL-23中位数为79.73(45.61,95.63)μg/L,明显高于良性前列腺增生组中位数30.88(15.01,44.94)μg/L(Z=22.66,P=0.000)及mCSPC组46.10(35.27,80.92)μg/L(Z=11.46,P=0.001);mCSPC组较良性前列腺增生组血清IL-23水平明显升高(Z=7.17,P=0.007)。亚组分析结果显示,mCRPC病情不稳定组患者血清IL-23中位值110.25(88.47,159.09)μg/L,明显高于mCRPC病情稳定组患者血清IL-23中位值46.52(44.97,80.33)μg/L(Z=33.99,P=0.000)。mCRPC病情稳定组血清IL-23水平46.52(44.97,80.33)μg/L,与mCSPC组患者46.10(35.27,80.92)μg/L比较差异无统计学意义(Z=0.35,P=0.554)。结论血清IL-23可作为预示mCSPC治疗效果及预警肿瘤转移的一个潜在生物学指标。

Objective To investigate the value of serum IL-23 in predicting the progression of prostate cancer at different stages of treatment.Methods A total of 124 patients with metastatic prostate cancer diagnosed in Beijing Hospital from June 2018 to March 2019 were collected.Patients were TNM-staged according to the Prostate Cancer Guidelines of the European Association of Urology.Serum IL-23 levels were measured in patients with metastatic castration resistance prostate cancer(mCRPC),metastatic castration sensitive prostate cancer(mCSPC)and benign prostatic hyperplasia(BPH),respectively.Patients with mCRPC were subgrouped based on disease stability,and serum IL-23 levels were compared between the subgroups.Serum IL-23 levels in the groups were analyzed and compared with the Gleason score and the prostate-specific antigen(PSA)level.Results The median value of serum IL-23 in the mCRPC group was 79.73(45.61,95.63)μg/L,which was higher than that in the BPH group[30.88(15.01,44.94)μg/L,Z=22.66,P=0.000]and the mCSPC group[46.10(35.27,80.92)μg/L,Z=11.46,P=0.001].Serum IL-23 levels were higher in the mCSPC group than in the BPH group(Z=7.17,P=0.007).Analysis for the subgroups showed that the median value of serum IL-23 was 110.25(88.47,159.09)μg/L in mCRPC patients with unstable disease,which was higher than that in mCRPC patients with stable disease[46.52(44.97,80.33)μg/L,Z=33.99,P=0.000].There was no significant difference in serum IL-23 levels between mCRPC patients with stable disease and mCSPC patients[46.10(35.27,80.92)μg/L](Z=0.35,P=0.554).Conclusions Serum IL-23 can be used as a potential biological indicator to predict the therapeutic effect of mCSPC and to predict tumor metastasis.