Department of Medical Oncology, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Biopolis, Larissa, 41110, Greece,
Clin Transl Oncol. 2013 Nov;15(11):903-9. doi: 10.1007/s12094-013-1021-5. Epub 2013 Mar 5.
Cancer patients usually develop malnutrition which may alter their innate immune system integrity. The aim of this study was to investigate the clinical relevance of chemokine response after lipopolysaccharide (LPS)-stimulation in metastatic non-small cell lung cancer (NSCLC).
Blood samples from metastatic NSCLC patients were incubated with LPS before the onset of systemic therapy. Interleukin (IL)-6 and IL-8 levels at baseline and after LPS-stimulation were measured and the fold change compared to baseline levels was evaluated as the stimulation index for each cytokine per patient. Results were correlated with sex, age, smoking status, histologic subtype, performance status (PS), albumin, Mini Nutritional Assessment (MNA) status and clinical outcomes.
Totally 103 patients were evaluated. Mean (±SD) stimulation index was 37.6 (±57.8) for IL-6 and 76.7 (±133.4) for IL-8. The disease control rate after first-line chemotherapy was 44/80 (55 %) and the mean (±SD) progression-free survival (PFS) and overall survival (OS) were 4.2 (±3.9) and 9.2 (±1.1) months, respectively. MNA, PS, albumin, IL-6 and IL-8 stimulation indices were univariately associated with PFS and OS. IL-8 stimulation index emerged as an independent predictor of both PFS and OS, along with PS, and albumin levels.
The extent of IL-6 and IL-8 stimulation after ex vivo induction with LPS is an important predictor of clinical outcome in metastatic NSCLC patients.
癌症患者通常会出现营养不良，这可能会改变其固有免疫系统的完整性。本研究旨在探讨脂多糖（LPS）刺激后转移性非小细胞肺癌（NSCLC）患者趋化因子反应的临床相关性。
在开始全身治疗之前，将转移性 NSCLC 患者的血液样本与 LPS 孵育。测量基线时和 LPS 刺激后白细胞介素（IL）-6 和 IL-8 水平，并评估每个患者每种细胞因子相对于基线水平的变化倍数作为刺激指数。结果与性别、年龄、吸烟状况、组织学亚型、表现状态（PS）、白蛋白、迷你营养评估（MNA）状况和临床结果相关。
共评估了 103 例患者。IL-6 的平均（±SD）刺激指数为 37.6（±57.8），IL-8 为 76.7（±133.4）。一线化疗后的疾病控制率为 44/80（55%），平均（±SD）无进展生存期（PFS）和总生存期（OS）分别为 4.2（±3.9）和 9.2（±1.1）个月。MNA、PS、白蛋白、IL-6 和 IL-8 刺激指数与 PFS 和 OS 均呈单变量相关。IL-8 刺激指数与 PS 和白蛋白水平一起，是 PFS 和 OS 的独立预测因子。
LPS 体外诱导后 IL-6 和 IL-8 的刺激程度是转移性 NSCLC 患者临床结局的重要预测因子。
