血清IL-31、IL-33水平与中晚期子宫内膜癌患者新辅助化疗效果的关系

Relationship between serum IL-31,IL-33 levels and the effect of neoadjuvant chemotherapy in patients with endometrial cancer in middle and late stages

目的分析血清白细胞介素-31(IL-31)、白细胞介素-33(IL-33)水平与中晚期子宫内膜癌患者新辅助化疗效果的关系。方法选取2017年1月至2020年1月在该院接受新辅助化疗[AP方案(阿霉素+顺铂化疗)]的123例中晚期子宫内膜癌患者作为研究对象,每3周为1个化疗周期,均化疗3个周期后观察至少1个月,评价入选者临床疗效并分为无效组和缓解组。比较两组一般资料、实验室指标水平,重点分析新辅助化疗前血清IL-31、IL-33水平与患者化疗无效的关系。结果123例中晚期子宫内膜癌患者经新辅助化疗3个周期后,无效组34例,无效率为27.64%,其中疾病稳定24例,疾病进展10例。无效组血清缺氧诱导因子1α(HIF-1α)、血管内皮生长因子(VEGF)、IL-31、IL-33水平均高于缓解组(P<0.05);组间其他资料比较差异均无统计学意义(P>0.05)。回归分析结果显示,化疗前血清HIF-1α、VEGF、IL-31、IL-33与中晚期子宫内膜癌患者化疗无效有关,上述指标过表达可能是中晚期子宫内膜癌患者化疗无效的风险因子(OR>1,P<0.05)。受试者工作特征(ROC)曲线结果显示,化疗前血清HIF-1α、VEGF、IL-31、IL-33水平预测中晚期子宫内膜癌患者化疗无效风险的曲线下面积(AUC)均>0.800,且化疗前血清HIF-1α、VEGF、IL-31、IL-33的最佳截断值分别为51.410 ng/L、233.597 pg/mL、170.991 pg/mL、108.163 pg/mL时,预测价值较理想。相关性分析结果显示,中晚期子宫内膜癌患者化疗前血清IL-31水平与IL-33水平呈正相关(r=0.338,P<0.05)。结论血清HIF-1α、VEGF、IL-31、IL-33水平与中晚期子宫内膜癌患者新辅助化疗无效有关,上述指标过表达可能是患者化疗无效的风险因子,且其对预测患者新辅助化疗无效风险有一定价值。

Objective To analyze the relationship between serum interleukin-31(IL-31),interleukin-33(IL-33)levels and the effect of neoadjuvant chemotherapy in patients with endometrial cancer in middle and late stages.Methods A total of 123 patients with endometrial cancer in middle and late stages who received neoadjuvant chemotherapy[AP regimen(adriamycin+cisplatin chemotherapy)]in the hospital from January 2017 to January 2020 were selected as research objects,every 3 weeks was a cycle of chemotherapy,and all the patients were observed for at least one month after 3 cycles of chemotherapy,and the clinical efficacy of selected patients was evaluated and the patients were divided into the ineffectiveness group and the remission group.General data and laboratory indexes between the two groups were compared,the relationship between serum IL-31,IL-33 before neoadjuvant chemotherapy and the ineffective chemotherapy of patients was mainly analyzed.Results Among the 123 patients with endometrial cancer in middle and late stages,34 patients were ineffective after 3 cycles of neoadjuvant chemotherapy,and the ineffective rate was 27.64%,of which 24 cases were stable and 10 cases were progressive in disease.The levels of serum HIF-1α,VEGF,IL-31 and IL-33 in the ineffectiveness group were higher than those in the remission group(P<0.05).There were no statistical significant differences on other data between the groups(P>0.05).Regression analysis showed that serum HIF-1α,VEGF,IL-31 and IL-33 levels before chemotherapy were related to the ineffective chemotherapy in patients with endometrial cancer in middle and late stages.The overexpression of above indexes might be a risk factor for the ineffective chemotherapy in patients with endometrial cancer in middle and late stages(OR>1,P<0.05).Receiver operating characteristic(ROC)curve results showed that the area under the curve(AUC)of serum HIF-1α,VEGF,IL-31 and IL-33 levels before chemotherapy in predicting the risk of ineffective chemotherapy in patients with endometrial cancer in middle and late stages were all>0.800,when the cut-off values of serum HIF-1α,VEGF,IL-31 and IL-33 before chemotherapy were 51.410 ng/L,233.597 pg/mL,170.991 pg/mL and 108.163 pg/mL,the predictive value was ideal.The correlation analysis results showed that there was a positive correlation between serum IL-31 level and IL-33 level before chemotherapy in patients with endometrial cancer in middle and late stages(r=0.338,P<0.05).Conclusion The levels of serum HIF-1α,VEGF,IL-31 and IL-33 are related to the ineffective neoadjuvant chemotherapy in patients with endometrial cancer in middle and late stages,which might be risk factors of ineffective chemotherapy in patients,and have certain value in predicting the risk of ineffectiveness after neoadjuvant chemotherapy.