Zhuang Qiulin, Meng Qingyang, Xi Qiulei, Wu Guohao
Department of General Surgery, Fudan University Affliated Zhongshan Hospital, Shanghai 200032, China.
Department of General Surgery, Fudan University Affliated Zhongshan Hospital, Shanghai 200032, China. Email:
Zhonghua Wei Chang Wai Ke Za Zhi. 2018 Nov 25;21(11):1285-1290.
To investigate the levels of serum inflammatory cytokines and Resolvin D1 (RvD1) and their association with pathological staging of colon cancer.
Clinical data of 50 colon cancer patients (colon cancer group) admitted to the General Surgery Department of Zhongshan Hospital of Fudan University from January to December 2016 and 5 ml of whole blood specimen were collected at admission. During the same period, 50 healthy volunteers were enrolled (healthy volunteer group). Inclusion criteria for the colon cancer group: colon cancer diagnosed by preoperative colonoscopy and pathology; no recent enteral or parenteral nutrition support treatment or use of oral nutrition preparation; age ≤85 years; no surgical contraindications by preoperative evaluation; no history of taking fish oil-related preparations; no radiotherapy or chemotherapy before surgery. Healthy volunteer group enrollment criteria: no history of malignant tumors; no organ with organic lesions detected by the healthy examination center of our hospital; detection indicators in normal reference range; no administration of fish oil-related preparations; age ≤ 85 years. Serum inflammatory factors(IL-1β, IL-6, IL-10 and TNF-α) concentrations were detected by chemiluminescence immunoassay; serum RvD1 concentration was measured by enzyme-linked immunosorbent assay. The levels of inflammatory factors and RvD1 were compared between the two groups, and their associations with TNM staging of colon cancer patients were analyzed.
There were no significant differences in age, gender and nutrition-related indicators between the two groups (all P>0.05). There were 31 males and 19 females in the healthy volunteer group with age of (61.8±11.6) years. There were 23 males and 27 females in the colon cancer group with age of (65.4±12.4) years. According to the 7th edition of the American Cancer Society TNM staging criteria, 10 cases were stage I, 13 cases stage II, 17 cases stage III, and 10 cases stage IV. Compared with healthy volunteer group, colon cancer group had higher serum IL-1β [(3.89±0.24)×10 μg/L vs.(1.55±0.37)×10 μg/L, t=37.52, P<0.01], higher IL-6 [(129.14±3.07)×10 μg/L vs.(51.46±3.14)×10 μg/L, t=125.08, P<0.01], higher IL-10 [(100.59±8.69)×103 μg/L vs.(27.57±4.77)×10 μg/L, t=52.09, P<0.01] and higher TNF-α [(114.31±4.43)×10 μg/L vs.(41.04±5.27)×10 μg/L, t=75.25, P<0.01], while lower RvD1 [(34.19±1.93)×10 μg/L vs.(77.76±1.02)×10 μg/L, t=140.56, P<0.01], all the differences were statistically significant. Subgroup analysis revealed that concentrations of IL-6, IL-1β, IL-10 and TNF-α gradually increased with the advancement of TNM staging (P<0.01). In stage III, concentrations of IL-6, IL-1β, and IL-10 were the highest, TNF-α concentration was the highest in stage IV. RvD1 concentration gradually decreased with the advancement of TNM staging(P<0.01).
Compared with healthy volunteers, the levels of serum inflammatory cytokines in colon cancer patients increase significantly while the level of RvD1 decreases significantly. Both are associated with higher TNM stage of colon cancer.
探讨血清炎性细胞因子及消退素D1（RvD1）水平及其与结肠癌病理分期的关系。
选取2016年1月至12月复旦大学附属中山医院普外科收治的50例结肠癌患者（结肠癌组），入院时采集5ml全血标本。同期选取50例健康志愿者（健康志愿者组）。结肠癌组纳入标准：经术前结肠镜及病理确诊为结肠癌；近期未接受肠内或肠外营养支持治疗或未使用口服营养制剂；年龄≤85岁；术前评估无手术禁忌证；无服用鱼油相关制剂史；术前未行放疗或化疗。健康志愿者组纳入标准：无恶性肿瘤病史；我院健康体检中心未检出有器质性病变的器官；检测指标在正常参考范围内；未服用鱼油相关制剂；年龄≤85岁。采用化学发光免疫分析法检测血清炎性因子（IL-1β、IL-6、IL-10和TNF-α）浓度；采用酶联免疫吸附测定法测定血清RvD1浓度。比较两组炎性因子及RvD1水平，并分析其与结肠癌患者TNM分期的关系。
两组患者年龄、性别及营养相关指标比较，差异均无统计学意义（均P>0.05）。健康志愿者组男31例，女19例，年龄（61.8±11.6）岁。结肠癌组男23例，女27例，年龄（65.4±12.4）岁。根据美国癌症协会第7版TNM分期标准，Ⅰ期10例，Ⅱ期13例，Ⅲ期17例，Ⅳ期10例。与健康志愿者组比较，结肠癌组血清IL-1β[（3.89±0.24）×10 μg/L vs.（1.55±0.37）×10 μg/L，t=37.52，P<0.01]、IL-6[（129.14±3.07）×10 μg/L vs.（51.46±3.14）×10 μg/L，t=125.08，P<0.01]、IL-10[（100.59±8.69）×103 μg/L vs.（27.57±4.77）×10 μg/L，t=52.09，P<0.01]和TNF-α[（114.31±4.43）×10 μg/L vs.（41.04±5.27）×10 μg/L，t=75.25，P<0.01]水平均升高，而RvD1水平降低[（34.19±1.93）×10 μg/L vs.（77.76±1.02）×10 μg/L，t=140.56，P<0.01]，差异均有统计学意义。亚组分析显示，IL-6、IL-1β、IL-10和TNF-α浓度随TNM分期进展逐渐升高（P<0.01）。Ⅲ期时，IL-6、IL-1β和IL-10浓度最高，Ⅳ期时TNF-α浓度最高。RvD1浓度随TNM分期进展逐渐降低（P<0.01）。
与健康志愿者相比，结肠癌患者血清炎性细胞因子水平显著升高，而RvD1水平显著降低。两者均与结肠癌较高的TNM分期相关。
