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血清白细胞介素-10水平作为晚期非小细胞肺癌患者的预后因素

Serum interleukin-10 levels as a prognostic factor in advanced non-small cell lung cancer patients.

作者信息

De Vita F, Orditura M, Galizia G, Romano C, Roscigno A, Lieto E, Catalano G

机构信息

Department of Clinical & Experimental Medicine "F. Magrassi," Second University of Naples School of Medicine, Naples, Italy.

出版信息

Chest. 2000 Feb;117(2):365-73. doi: 10.1378/chest.117.2.365.

Abstract

STUDY OBJECTIVE

To investigate the prognostic significance of interleukin (IL)-10 serum levels in advanced non-small cell lung cancer (NSCLC) patients.

DESIGN

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.

SETTING

University hospital.

PATIENTS

Sixty consecutive patients with TNM stage III or IV NSCLC undergoing conventional platinum-based regimens.

RESULTS

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.

CONCLUSIONS

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.

摘要

研究目的

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。

设计

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。

研究地点

大学医院。

患者

60例连续的TNM III期或IV期NSCLC患者接受传统铂类方案治疗。

结果

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。

结论

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。

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