De Vita F, Orditura M, Galizia G, Romano C, Roscigno A, Lieto E, Catalano G
Department of Clinical & Experimental Medicine "F. Magrassi," Second University of Naples School of Medicine, Naples, Italy.
Chest. 2000 Feb;117(2):365-73. doi: 10.1378/chest.117.2.365.
To investigate the prognostic significance of interleukin (IL)-10 serum levels in advanced non-small cell lung cancer (NSCLC) patients.
IL-10 serum levels were measured before chemotherapy, on completion of therapy, and at follow-up by means of a commercially available enzyme-linked immunoassay. The results were then analyzed in comparison with other prognostic variables, and a model predicting overall survival (OS) and time to treatment failure (TTF) was finally generated.
University hospital.
Sixty consecutive patients with TNM stage III or IV NSCLC undergoing conventional platinum-based regimens.
Elevated levels of serum IL-10 were found in cancer patients with respect to healthy control subjects (17.7 +/- 4.4 vs 9.2 +/- 1.5 pg/mL, respectively; p < 0.05), with patients with metastatic disease showing significantly higher levels than patients with undisseminated cancer (21.0 +/- 4.2 vs 14.3 +/- 1.2 pg/mL, respectively; p < 0.05). Following completion of treatment, patients were classified as responders if they had achieved either one of the following: complete response, partial response, or stable disease; and nonresponders, in case of progressive disease. Retrospective analysis of basal IL-10 serum levels in these two subgroups showed a significant difference between responders and nonresponders (15.2 +/- 2.2 vs 21.4 +/- 4.2 pg/mL, respectively; p < 0.05). Moreover, a further significant increase in IL-10 serum levels was observed in nonresponders at the end of therapy (21.4 +/- 4.2 vs 26.0 +/- 4.3 pg/mL, prechemotherapy and postchemotherapy, respectively; p < 0.05), whereas values in responders were found to have significantly decreased (15.2 +/- 2.2 vs 14.8 +/- 2.2 pg/mL, prechemotherapy and postchemotherapy, respectively; p < 0.05). Using univariate and multivariate analyses, both OS and TTF were shown to be affected by the mean pathologic levels of IL-10. Stepwise regression analysis identified IL-10 serum level and stage as the prognostic factors related to OS, and IL-10 serum level and performance status as the prognostic factors related to TTF.
In conclusion, this study shows that the measurement of pretreatment IL-10 serum levels is of independent prognostic utility in patients with NSCLC and may be useful for detection of disease progression.
探讨白细胞介素(IL)-10血清水平在晚期非小细胞肺癌(NSCLC)患者中的预后意义。
采用市售酶联免疫分析法在化疗前、治疗结束时及随访时检测IL-10血清水平。然后将结果与其他预后变量进行比较分析,最终建立预测总生存期(OS)和治疗失败时间(TTF)的模型。
大学医院。
60例连续的TNM III期或IV期NSCLC患者接受传统铂类方案治疗。
与健康对照者相比,癌症患者血清IL-10水平升高(分别为17.7±4.4 vs 9.2±1.5 pg/mL;p<0.05),转移性疾病患者的水平显著高于未播散癌症患者(分别为21.0±4.2 vs 14.3±1.2 pg/mL;p<0.05)。治疗结束后,若患者达到以下任何一种情况则分类为缓解者:完全缓解、部分缓解或疾病稳定;若为疾病进展则为未缓解者。对这两个亚组的基础IL-10血清水平进行回顾性分析显示,缓解者与未缓解者之间存在显著差异(分别为15.2±2.2 vs 21.4±4.2 pg/mL;p<0.05)。此外,未缓解者在治疗结束时IL-10血清水平进一步显著升高(化疗前和化疗后分别为21.4±4.2 vs 26.0±4.3 pg/mL;p<0.05),而缓解者的值显著降低(化疗前和化疗后分别为15.2±2.2 vs 14.8±2.2 pg/mL;p<0.05)。单因素和多因素分析显示,OS和TTF均受IL-10的平均病理水平影响。逐步回归分析确定IL-10血清水平和分期为与OS相关的预后因素,IL-10血清水平和体能状态为与TTF相关的预后因素。
总之,本研究表明,检测治疗前IL-10血清水平对NSCLC患者具有独立的预后价值,可能有助于疾病进展的检测。