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关键胃肠道癌症患者中白细胞介素-2、白细胞介素-8、肿瘤坏死因子-α、降钙素原及C反应蛋白的预测价值剖析

Predictive values profiling of interleukin-2, interleukin-8, tumor necrosis factor-α, procalcitonin, and C-reactive protein in critical gastrointestinal cancer patients.

作者信息

Yan Yamin, Yu Zhenghong, Lu Jingjing, Jin Peili, Tang Zhaoqing, Hu Yan

机构信息

Nursing Department, Zhongshan Hospital, Fudan University, Shanghai, China.

General Surgery Department, Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

J Gastrointest Oncol. 2021 Aug;12(4):1398-1406. doi: 10.21037/jgo-21-334.

Abstract

BACKGROUND

The prognostic values of serum cytokines in cancer have not yet been fully determined. The objective of this study was to identify potential biomarkers associated with clinical outcomes in critical gastrointestinal (GI) cancer patients.

METHODS

A retrospective analysis was performed to quantify serum interleukin (IL)-2, IL-8, tumor necrosis factor-α (TNF-α), procalcitonin (PCT), and C-reactive protein (CRP) for correlation with clinical outcomes in GI cancer patients. The patients were divided into tertiles or quartiles based on the cytokine levels: Q1, Q2, and Q3, or Q1, Q2, Q3, and Q4. Receiver operating characteristic (ROC) curves were drawn to determine the optimal cutoff values of the cytokines.

RESULTS

Trend analysis showed that IL-2, IL-8, TNF-α, PCT, and CRP levels had significant positive correlations with mortality in GI cancer patients (all P-values were lower than 0.05). The significance was observed in Q3 Q1 in IL-2 (P=0.026), Q3 Q1 in IL-8 (P=0.003), Q2 and Q3 Q1 in TNF-α (P=0.012 and P=0.002, respectively), Q4 Q1 in PCT (P=0.031), Q3 and Q4 Q1 in CRP (P=0.011 and P=0.001, respectively). The area under curve (AUC) of IL-2, IL-8, TNF-α, PCT, and CRP were 0.706, 0.729, 0.743, 0.769, and 0.736, and the optimal cutoff points were determined at 838 U/mL, 46.15 pg/mL, 11.95 pg/mL, 0.77 pg/mL, and 109.38 mg/L, respectively. Under these critical values, the sensitivity was 73.3%, 66.7%, 80.0%, 93.3%, and 86.7%, and the specificity was 64.9%, 72.0%, 60.4%, 61.8%, and 68.9%, respectively.

CONCLUSIONS

In GI cancer patients, serum IL-2, IL-8, TNF-α, PCT, and CRP levels can provide potential prognostic values for predicting clinical outcomes. The results may facilitate the exploration of cancer-related cytokine networks and development of novel therapy for GI cancer patients.

摘要

背景

血清细胞因子在癌症中的预后价值尚未完全确定。本研究的目的是确定与重症胃肠(GI)癌患者临床结局相关的潜在生物标志物。

方法

进行回顾性分析,以量化血清白细胞介素(IL)-2、IL-8、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)和C反应蛋白(CRP),并与GI癌患者的临床结局进行相关性分析。根据细胞因子水平将患者分为三分位数或四分位数:Q1、Q2和Q3,或Q1、Q2、Q3和Q4。绘制受试者工作特征(ROC)曲线以确定细胞因子的最佳临界值。

结果

趋势分析表明,IL-2、IL-8、TNF-α、PCT和CRP水平与GI癌患者的死亡率呈显著正相关(所有P值均低于0.05)。在IL-2中,Q3与Q1相比差异有统计学意义(P = 0.026);在IL-8中,Q3与Q1相比差异有统计学意义(P = 0.003);在TNF-α中,Q2和Q3与Q1相比差异有统计学意义(分别为P = 0.012和P = 0.002);在PCT中,Q4与Q1相比差异有统计学意义(P = 0.031);在CRP中,Q3和Q4与Q1相比差异有统计学意义(分别为P = 0.011和P = 0.001)。IL-2、IL-8、TNF-α、PCT和CRP的曲线下面积(AUC)分别为0.706、0.729、0.743、0.769和0.736,最佳临界点分别确定为838 U/mL、46.15 pg/mL、11.95 pg/mL、0.77 pg/mL和109.38 mg/L。在这些临界值下,敏感性分别为73.3%、66.7%、80.0%、93.3%和86.7%,特异性分别为64.9%、72.0%、60.4%、61.8%和68.9%。

结论

在GI癌患者中,血清IL-2、IL-8、TNF-α、PCT和CRP水平可为预测临床结局提供潜在的预后价值。这些结果可能有助于探索癌症相关的细胞因子网络,并为GI癌患者开发新的治疗方法。

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本文引用的文献

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Cytokines in the Treatment of Cancer.细胞因子在癌症治疗中的应用。
J Interferon Cytokine Res. 2019 Jan;39(1):6-21. doi: 10.1089/jir.2018.0019. Epub 2018 Jun 11.

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