Academic Unit of Surgery, School of Medicine, University of Glasgow, Royal Infirmary, Glasgow, UK.
Cancer Treat Rev. 2013 Feb;39(1):89-96. doi: 10.1016/j.ctrv.2012.07.003. Epub 2012 Aug 2.
Cancer-associated inflammation has been identified as a key determinant of disease progression and survival in colorectal cancer. In particular, it has been consistently reported that both the local and systemic inflammatory responses play an important role in determining outcome in colorectal cancer. Given the importance of cancer-associated inflammation, up-regulation or attenuation of these respective inflammatory responses may be important for progression and survival in colorectal cancer. Recent work has focused on the inter-relationships between the tumour and these key inflammatory processes. In particular, tumour necrosis has been reported to be associated with decreased local inflammatory infiltrate and with elevated markers of systemic inflammation in colorectal cancer and has been proposed as a potential link between the systemic and local inflammatory responses. Thus there is increasing interest in the potential biochemical mediators of this link. In this review we examine the evidence for IL-6 in the natural history of colorectal cancer and its relationship with tumour necrosis and the local and systemic inflammatory responses. There is now good evidence that tumour concentrations of IL-6 have been directly associated with increased necrosis, proliferation, differentiation and vascular invasion, while circulating concentrations of IL-6 are directly associated with T-stage, CRP concentrations and poorer survival. Also, interleukin-6 and down-stream pathways, such as the JAK/STAT pathway, have emerged as important factors in the modulation of cancer-associated inflammation. Therefore, IL-6 has emerged as a key mediator of the relationship between tumour necrosis, local and systemic inflammatory responses and outcome in patients with colorectal cancer.
癌症相关炎症已被确定为结直肠癌疾病进展和生存的关键决定因素。特别是，一直有报道称，局部和全身炎症反应在确定结直肠癌的预后中起着重要作用。鉴于癌症相关炎症的重要性，上调或下调这些炎症反应可能对结直肠癌的进展和生存至关重要。最近的研究集中在肿瘤与这些关键炎症过程之间的相互关系上。特别是，已经报道肿瘤坏死与局部炎症浸润减少和结直肠癌全身炎症标志物升高有关，并被提议作为全身和局部炎症反应之间的潜在联系。因此，人们对这种联系的潜在生化介质越来越感兴趣。在这篇综述中，我们检查了白细胞介素 6 在结直肠癌自然史中的证据及其与肿瘤坏死以及局部和全身炎症反应的关系。现在有充分的证据表明，肿瘤中白细胞介素 6 的浓度与增加的坏死、增殖、分化和血管浸润直接相关，而循环中白细胞介素 6 的浓度与 T 期、C 反应蛋白浓度和较差的生存率直接相关。此外，白细胞介素 6 和下游途径，如 JAK/STAT 途径，已成为调节癌症相关炎症的重要因素。因此，白细胞介素 6 已成为肿瘤坏死、局部和全身炎症反应与结直肠癌患者预后之间关系的关键介质。
