Laboratory Experimental Surgical Oncology, Section Surgical Oncology, Department of Surgery, Erasmus MC, Rotterdam 3015 GE, The Netherlands.
Melanoma Res. 2011 Aug;21(4):344-51. doi: 10.1097/CMR.0b013e328346c17f.
Adjuvant therapy with interferon-α (IFN) only benefits a small subgroup of melanoma patients and a predictive marker selecting responders does not exist. IFN induces increased ferritin and decreased C-reactive protein (CRP) levels; however, an association with treatment effect was not studied. Serum was collected from patients participating in the European Organization for Research and Treatment of Cancer 18 952 trial comparing adjuvant treatment with IFN to observation. Serial ferritin and CRP levels were determined using enzyme-linked immunosorbent assays, before treatment and up to 24 months. Ferritin levels are influenced by sex and age; therefore ratios of serial ferritin and CRP values with corresponding pretreatment values were calculated. Cox regression model and landmark method at end of induction and 6 months were used to evaluate the association between ferritin, CRP and distant metastasis-free survival (DMFS). Baseline ferritin levels were comparable in the two treatment groups (P=0.92). However, ferritin ratios were significantly higher in IFN-treated patients (N=96) compared with untreated patients (N=21) at end of induction (mean: 2.88 vs. 0.75; P=0.0003) and at 6 months (mean: 3.18 vs. 1.02; P=0.009). In the IFN arm, higher ferritin ratios at end of induction and at 6 months were not associated with improved outcome (respectively, P=0.66 and 0.86). Concerning CRP ratios, no differences between the treatment groups, neither an association with DMFS, were observed. Administration of IFN in melanoma patients induced increase in ferritin levels but not in CRP levels. Ferritin and CRP ratios have no prognostic value regarding DMFS.
辅助治疗用干扰素-α（IFN）仅使一小部分黑色素瘤患者受益，且不存在选择应答者的预测标志物。IFN 可诱导铁蛋白增加和 C 反应蛋白（CRP）水平降低；然而，其与治疗效果的相关性尚未研究。从参加欧洲癌症研究与治疗组织 18952 试验的患者中收集血清，该试验比较了辅助用 IFN 治疗与观察的效果。在治疗前和治疗后 24 个月内，使用酶联免疫吸附测定法测定铁蛋白和 CRP 的连续水平。铁蛋白水平受性别和年龄的影响；因此，计算了铁蛋白和 CRP 值与相应预处理值的比值。使用 Cox 回归模型和里程碑方法在诱导结束和 6 个月时，评估铁蛋白、CRP 与无远处转移生存率（DMFS）之间的关系。两组患者的基线铁蛋白水平相当（P=0.92）。然而，在诱导结束时（平均：2.88 对 0.75；P=0.0003）和 6 个月时（平均：3.18 对 1.02；P=0.009），IFN 治疗组的铁蛋白比值明显更高。在 IFN 组中，诱导结束和 6 个月时较高的铁蛋白比值与改善结局无关（分别为 P=0.66 和 0.86）。关于 CRP 比值，在两组之间未观察到差异，也与 DMFS 无关。在黑色素瘤患者中给予 IFN 可诱导铁蛋白水平升高，但 CRP 水平无变化。铁蛋白和 CRP 比值对于 DMFS 无预后价值。
