National Centre for Asbestos Related Disease, University of Western Australia, Nedlands, WA, Australia.
Faculty of Health and Medical Science, University of Western Australia, Nedlands, WA, Australia.
Cancer Biomark. 2022;33(1):159-169. doi: 10.3233/CBM-210280.
Pleural mesothelioma is a deadly asbestos induced cancer. Less than 10% of mesothelioma patients survive 5 years post diagnosis. However survival can range from a few months to a number of years. Accurate prediction of survival is important for patients to plan for their remaining life, and for clinicians to determine appropriate therapy. One unusual feature of mesothelioma is that patients frequently present with tumor-associated pleural effusions early in the course of the disease.
To study whether cells and molecules present in pleural effusions provide prognostic information for mesothelioma.
We profiled the cellular constituents and concentrations of 40 cytokines, chemokines and cellular factors (collectively "soluble factors") involved in inflammatory and immune signalling pathways in pleural effusion samples from 50 mesothelioma patients.Associations with survival were evaluated by Cox proportional hazards regression methods. Results for the two soluble factors most significantly and independently associated with survival were validated in an independent set of samples (n= 51) using a separate assay system.
Survival analysis revealed that IL8, IL2Ra (CD25) and PF4 were independent determinants of a more negative prognosis in mesothelioma patients, independent of other known prognostic factors. Lipocalin2 and IL4 were associated with better prognosis.
This study demonstrates that pleural effusions rich in a range of soluble factors are associated with poor prognosis. These findings will enhance our ability to prognosticate outcomes in mesothelioma patients.
胸膜间皮瘤是一种致命的石棉诱导癌症。不到 10%的间皮瘤患者在诊断后能存活 5 年。然而，存活时间可以从几个月到数年不等。准确预测生存情况对患者规划剩余生命以及临床医生确定适当的治疗方法都很重要。间皮瘤的一个不寻常特征是，患者在疾病早期经常出现与肿瘤相关的胸腔积液。
研究胸腔积液中的细胞和分子是否为间皮瘤提供预后信息。
我们对 50 名间皮瘤患者的胸腔积液样本中的细胞成分和 40 种细胞因子、趋化因子和细胞因子（统称为“可溶性因子”）的浓度进行了分析，这些因子涉及炎症和免疫信号通路。通过 Cox 比例风险回归方法评估与生存的相关性。使用另一种检测系统，在一组独立的样本（n=51）中验证了与生存显著和独立相关的两种可溶性因子的结果。
生存分析表明，IL8、IL2Ra（CD25）和 PF4 是间皮瘤患者预后更差的独立决定因素，与其他已知的预后因素无关。脂联素 2 和 IL4 与较好的预后相关。
本研究表明，富含多种可溶性因子的胸腔积液与预后不良有关。这些发现将增强我们预测间皮瘤患者预后的能力。
