IL-6和YKL-40在头颈部鳞状细胞癌患者预后评估中的价值

Prognostic evaluation of IL-6 combined with YKL-40 in head and neck squamous cell carcinoma

目的探讨白细胞介素(IL)-6和人类软骨糖蛋白39(YKL-40)在头颈部鳞状细胞癌(HNSCC)患者预后评估中的价值。方法选取HNSCC患者130例,检测其治疗前血清IL-6和YKL-40水平,同时收集相关临床资料。对所有患者进行随访,以全因死亡为随访终点。采用受试者工作特征(ROC)曲线确定IL-6和YKL-40判断HNSCC患者预后的最佳临界值。采用Kaplan-Meier曲线分析HNSCC患者的生存情况。采用Cox比例风险回归模型分析影响HNSCC患者总生存期的危险因素。结果ROC曲线分析结果显示,IL-6和YKL-40判断HNSCC患者预后的最佳临界值分别为19.8 pg/mL和119μg/L。与IL-6≤19.8 pg/mL组比较,IL-6>19.8 pg/mL组TNM分期Ⅲ期和Ⅳ期患者所占比例显著升高(P<0.05);2个组之间性别、年龄、肿瘤部位和治疗方式差异均无统计学意义(P>0.05)。与YKL-40≤119μg/L组比较,YKL-40>119μg/L组年龄和TNM分期Ⅲ期、Ⅳ期患者所占比例显著升高(P<0.05);2个组之间性别、肿瘤部位和治疗方式差异均无统计学意义(P>0.05)。IL-6>19.8 pg/mL组、YKL-40>119μg/L组中位生存期分别显著短于IL-6≤19.8 pg/mL组和YKL-40≤119μg/L组(P<0.001、P=0.002)。Cox比例风险回归分析结果显示,TNM分期、IL-6和YKL-40是影响HNSCC患者总生存期的危险因素[风险比(HR)值分别为2.65、1.78、1.69,95%可信区间(CI)分别为1.64~5.64、1.43~3.07、1.28~2.10]。结论IL-6、YKL-40与HNSCC患者预后有关,二者联合检测或可用于评估患者预后。

Objective To investigate the prognostic roles of interleukin(IL)-6 and cartilage glycoprotein 39(YKL-40)for evaluating all-cause mortality in patients with head and neck squamous cell carcinoma(HNSCC).Methods The data from 130 patients with HNSCC were analyzed.Serum IL-6 and YKL-40 were determined.All the patients were followed up,and the primary endpoint was all-cause mortality.Receiver operating characteristic(ROC)curve was used to determine the optimal cut-off values for the prognosis of HNSCC patients by IL-6 and YKL-40.Kaplan-Meier curve was used to analyze the survival of HNSCC patients.Cox proportional hazard model was used to determine risk factors for overall survival in patients with HNSCC.Results The optimal cut-off values of IL-6 and YKL-40 were 19.8 pg/mL and 119μg/L.Compared with IL-6≤19.8 pg/mL,patients in IL-6>19.8 pg/mL had increased proportions of stageⅢandⅣin TNM classification(P<0.05).There was no statistical significance for sex,age,tumor location and treatment method between the 2 groups(P>0.05).Increased age and proportions of stageⅢandⅣwere also noticed in YKL-40>119μg/L group as compared with those in YKL-40≤119μg/L group(P<0.05).There was no statistical significance in sex,tumor location and treatment method between the 2 groups(P>0.05).Survival analysis indicated that patients in IL-6>19.8 pg/mL group and YKL-40>119μg/L group had reduced median survival time as compared with those in IL-6≤19.8 pg/mL group(P<0.001)and YKL-40≤119μg/L group(P=0.002).Cox regression analysis showed that TNM classification[hazard ratio(HR)=2.65,95%confidence interval(CI)1.64-5.64],IL-6(HR=1.78,95%CI 1.43-3.07)and YKL-40(HR=1.69,95%CI 1.28-2.10)were risk factors for overall survival in patients with HNSCC.Conclusions IL-6 and YKL-40 are related to the prognosis of HNSCC patients,and the combined determination can be used in evaluating patients'prognosis.