Kita Hidefumi, Shiraishi Yuji, Watanabe Kenichi, Suda Kazuharu, Ohtsuka Kouki, Koshiishi Yoshihiko, Goya Tomoyuki
Section of Chest Surgery, Fukujuji Hospital, 3-1-24 Matsuyama, Kiyose, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2011;17(5):454-60. doi: 10.5761/atcs.oa.10.01627. Epub 2011 Jul 13.
We examined the influence of inflammatory cytokine levels on postoperative early recurrence in patients who underwent curative lung cancer surgery.
In 107 patients who underwent curative pulmonary resections for non-small cell lung cancer (NSCLC) from November 2007 to June 2008, we measured serum interleukin-6 (IL-6) levels preoperatively, and on postoperative day (POD) 0, 1, and 2. Between July 2009 and August 2009, 1 year after the date of enrollment of the last patient, we investigated survival status of each patient and identified a group with recurrence.
Among 107 patients, 29 patients developed recurrence with a mean follow-up of 18.1 months (range 14 to 21). P-stage was significantly more advanced in the recurrence group than in the non-recurrence group (p = 0.005). Serum IL-6 levels on POD 1 were significantly higher in the recurrence group than in the non-recurrence group (p = 0.007). In Cox's proportional hazards regression, P-stage and serum IL-6 levels on POD 1 were significant independent predicting factors for postoperative early recurrence (p = 0.006, p = 0.003).
The higher the serum IL-6 levels on POD 1, the higher the risk of early postoperative recurrence, even when curative pulmonary resection can be accomplished in lung cancer patients.
我们研究了炎性细胞因子水平对接受肺癌根治性手术患者术后早期复发的影响。
在2007年11月至2008年6月期间接受非小细胞肺癌(NSCLC)根治性肺切除术的107例患者中,我们在术前、术后第0天、第1天和第2天测量了血清白细胞介素-6(IL-6)水平。在2009年7月至2009年8月,即最后一名患者入组日期的1年后,我们调查了每位患者的生存状况并确定了复发组。
107例患者中,29例出现复发,平均随访18.1个月(范围14至21个月)。复发组的P分期明显比非复发组更晚(p = 0.005)。复发组术后第1天的血清IL-6水平明显高于非复发组(p = 0.007)。在Cox比例风险回归分析中,P分期和术后第1天的血清IL-6水平是术后早期复发的显著独立预测因素(p = 0.006,p = 0.003)。
即使肺癌患者能够完成根治性肺切除术,术后第1天血清IL-6水平越高,术后早期复发的风险就越高。