Tsushima H, Ito N, Tamura S, Matsuda Y, Inada M, Yabuuchi I, Imai Y, Nagashima R, Misawa H, Takeda H, Matsuzawa Y, Kawata S
Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan.
Clin Cancer Res. 2001 May;7(5):1258-62.
Plasma transforming growth factor beta1 (TGF-beta1) has been reported to be correlated with the extent of disease in colorectal cancer, but it is not known whether measuring this cytokine can help predict liver metastasis after curative resection. We prospectively studied whether plasma TGF-beta1 levels could predict liver metastasis in 117 patients with colorectal cancer before and after curative resection. Blood samples were drawn before and 2 weeks after surgery to determine the cytokine levels. Abdominal ultrasonography or computed tomography was done every 3 months after surgery. The primary end point for follow-up was recurrence. Seventy-seven of 117 cases (66%) had preoperative levels of the cytokine higher than the borderline limit of 7.5 ng/ml. Postoperative levels were >7.5 ng/ml in 29 of 117 patients (25%). The median follow-up period was 42 months (range, 5--66 months), with follow-up of all 117 patients. No recurrence was observed in 13 patients with Dukes' stage A lesions. Liver metastasis occurred in 18 of 104 patients (17%) with Dukes' stage B or C disease. Fourteen of 18 patients (78%) who developed liver metastasis had shown a postoperative plasma TGF-beta1 level of >7.5 ng/ml. Cox proportional hazards regression analysis showed that the postoperative level was a significant predictive factor for liver metastasis (P < 0.001). A single point measurement of plasma TGF-beta1 levels at 2 weeks after curative resection seems to be able to predict liver metastasis in colorectal cancer. This finding suggests the value of a prospective trial of liver-targeted adjuvant therapy for patients with elevated postoperative plasma TGF-beta1 levels.
据报道，血浆转化生长因子β1（TGF-β1）与结直肠癌的疾病范围相关，但尚不清楚检测这种细胞因子是否有助于预测根治性切除术后的肝转移。我们前瞻性地研究了117例结直肠癌患者根治性切除前后血浆TGF-β1水平是否能够预测肝转移。在手术前和手术后2周采集血样以测定细胞因子水平。术后每3个月进行腹部超声或计算机断层扫描。随访的主要终点是复发。117例患者中有77例（66%）术前细胞因子水平高于临界值7.5 ng/ml。117例患者中有29例（25%）术后水平>7.5 ng/ml。117例患者均获随访，中位随访期为42个月（范围5 - 66个月）。13例Dukes A期病变患者未观察到复发。104例Dukes B或C期疾病患者中有18例（17%）发生肝转移。发生肝转移的18例患者中有14例（78%）术后血浆TGF-β1水平>7.5 ng/ml。Cox比例风险回归分析显示，术后水平是肝转移的显著预测因素（P < 0.001）。根治性切除术后2周单次测定血浆TGF-β1水平似乎能够预测结直肠癌的肝转移。这一发现提示了对术后血浆TGF-β1水平升高的患者进行肝靶向辅助治疗前瞻性试验的价值。
