Ramsey S, Lamb G W A, Aitchison M, McMillan D C
Department of Urology, Gartnavel General Hospital, 1053 Great Western Rd, Glasgow G12 OYN, UK.
Br J Cancer. 2006 Oct 23;95(8):1076-80. doi: 10.1038/sj.bjc.6603387. Epub 2006 Sep 26.
The systemic inflammatory response, as evidenced by elevated circulating concentrations of C-reactive protein, is a stage-independent prognostic factor in patients undergoing curative nephrectomy for localised renal cancer. However, it is not clear whether the systemic inflammatory response arises from the tumour per se or as a result of an impaired immune cytokine response. The aim of the present study was to examine C-reactive protein, interleukin-6 and interleukin-10 concentrations before and following curative resection of renal cancer. Sixty-four patients with malignant renal disease and 12 with benign disease, undergoing resection were studied. Preoperatively, a blood sample was collected for routine laboratory analysis with a further sample stored before analysis of interleukin-6 and interleukin-10 using an enzyme-linked immunosorbent assay (ELISA) technique. The blood sampling procedure and analyses were repeated at approximately 3 months following resection. Circulating concentrations of both interleukin-6 and interleukin (P< or =0.01) were higher and a greater proportion were elevated (P<0.05) in malignant compared with benign disease. The renal cancer patients were grouped according to whether they had evidence of a systemic inflammatory response. In the inflammatory group T stage was higher (P<0.01), both interleukin-6 and interleukin-10 concentrations were higher (P<0.001) and elevated (P<0.10) compared with the non-inflammatory group. Tumour volume was weakly correlated with C-reactive protein (r(2)=0.20, P=0.002), interleukin-6 (r(2)=0.20, P=0.002) and interleukin-10 (r(2)=0.24, P=0.001). Following nephrectomy the proportion of patients with elevated C-reactive protein, interleukin-6 and interleukin-10 concentrations did not alter significantly. An elevated preoperative C-reactive protein was associated with increased tumour stage, interleukin-6 and interleukin-10 concentrations. However, resection of the primary tumour did not appear to be associated with significant normalisation of circulating concentrations of C-reactive protein, interleukin-6 or interleukin-10. Therefore, the presence of systemic inflammatory response is unlikely to be solely be determined by the tumour itself, but may be as a result of an impaired immune cytokine response in patients with renal cancer.
全身性炎症反应，如循环中C反应蛋白浓度升高所证明的，是接受局限性肾癌根治性肾切除术患者的一个与分期无关的预后因素。然而，目前尚不清楚全身性炎症反应是源于肿瘤本身还是免疫细胞因子反应受损的结果。本研究的目的是检测肾癌根治性切除术前和术后C反应蛋白、白细胞介素-6和白细胞介素-10的浓度。对64例患有恶性肾病和12例患有良性疾病且正在接受手术切除的患者进行了研究。术前采集血样进行常规实验室分析，并在使用酶联免疫吸附测定（ELISA）技术分析白细胞介素-6和白细胞介素-10之前再保存一份血样。在切除术后约3个月重复进行血样采集程序和分析。与良性疾病相比，恶性疾病患者循环中的白细胞介素-6和白细胞介素（P≤0.01）浓度更高，且升高的比例更大（P<0.05）。根据是否有全身性炎症反应的证据对肾癌患者进行分组。在炎症组中，T分期更高（P<0.01），白细胞介素-6和白细胞介素-10浓度更高（P<0.001），与非炎症组相比升高（P<0.10）。肿瘤体积与C反应蛋白（r²=0.20，P=0.002）、白细胞介素-6（r²=0.20，P=0.002）和白细胞介素-10（r²=0.24，P=0.001）呈弱相关。肾切除术后C反应蛋白、白细胞介素-6和白细胞介素-10浓度升高的患者比例没有显著变化。术前C反应蛋白升高与肿瘤分期增加、白细胞介素-6和白细胞介素-10浓度升高有关。然而，原发肿瘤的切除似乎与C反应蛋白、白细胞介素-6或白细胞介素-10循环浓度的显著正常化无关。因此，全身性炎症反应的存在不太可能仅由肿瘤本身决定，而可能是肾癌患者免疫细胞因子反应受损的结果。
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