Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Clinical Research Center, Nanfang Hospital, Southern Medical University, Guangzhou, China.
J Immunol Res. 2022 Jul 8;2022:7863480. doi: 10.1155/2022/7863480. eCollection 2022.
Little is known about the relation between perioperative inflammatory changes and long-term survival in cancer patients. The aim of the study was to assess the association of perioperative serum interleukin-6 (IL6) and tumor necrosis factor- (TNF) levels with the 5-year overall survival in locally advanced gastric cancer.
The 135 eligible patients in one center of Nanfang Hospital were retrieved from CLASS-01 trial (NCT01609309), an open-label, multicenter, randomized clinical noninferiority trial conducted at 14 centers in China. Serum IL6 and TNF levels were tested before surgery, and on postoperative day (POD) 1, POD3, and POD5, respectively, referring to IL6_0, IL6_1, IL6_3, and IL6_5 and TNF_0, TNF_1, TNF_3, and TNF_5. Kaplan-Meier methods and COX models were used for survival analysis.
High levels of IL6_0 (≥3.67 pg/mL) and TNF_0 (≥14.8 pg/mL) presented worse disease-free survival (DFS) ( = 0.0057 for IL6_0 and = 0.0014 for TNF_0) and overall survival (OS) ( = 0.0021 for IL6_0 and = 0.0019 for TNF_0). Both high IL6_0 and high IL6_5 levels indicated worse prognosis than other combinations ( = 0.0045 for DFS and = 0.0022 for OS). In multivariate analysis, both high IL6_0 and high IL6_5 levels were significantly associated with poor DFS (HR = 4.29, 95% CI: 1.42-12.95, = 0.01) and OS (HR = 4.11, 95% CI: 1.35-12.49, = 0.013) after adjustment of tumor stage and TNF_0. Also, high IL6_5 level was identified as the independent-related factor for postoperative infectious complications (OR = 2.69, 95% CI: 1.03-7.01, = 0.043).
Perioperative high serum IL6 and TNF levels are negatively associated with 5-year survival outcomes in patients with locally advanced gastric cancer, indicating the potential survival benefits from perioperative anti-inflammatory treatment.
关于围手术期炎症变化与癌症患者长期生存之间的关系知之甚少。本研究旨在评估局部晚期胃癌患者围手术期血清白细胞介素 6（IL6）和肿瘤坏死因子-（TNF）水平与 5 年总生存率的关系。
从 CLASS-01 试验（NCT01609309）中检索了 135 名符合条件的患者，该试验是一项在中国 14 个中心进行的开放标签、多中心、随机临床非劣效性试验。分别在术前、术后第 1 天（POD1）、第 3 天（POD3）和第 5 天（POD5）检测血清 IL6 和 TNF 水平，分别对应 IL6_0、IL6_1、IL6_3 和 IL6_5 和 TNF_0、TNF_1、TNF_3 和 TNF_5。使用 Kaplan-Meier 方法和 COX 模型进行生存分析。
高水平的 IL6_0（≥3.67pg/mL）和 TNF_0（≥14.8pg/mL）提示无病生存期（DFS）较差（IL6_0=0.0057，TNF_0=0.0014）和总生存期（OS）较差（IL6_0=0.0021，TNF_0=0.0019）。高 IL6_0 和高 IL6_5 水平均提示预后较差（DFS=0.0045，OS=0.0022）。多变量分析显示，高 IL6_0 和高 IL6_5 水平均与较差的 DFS（HR=4.29，95%CI：1.42-12.95，=0.01）和 OS（HR=4.11，95%CI：1.35-12.49，=0.013）显著相关，调整肿瘤分期和 TNF_0 后。此外，高 IL6_5 水平也被确定为术后感染性并发症的独立相关因素（OR=2.69，95%CI：1.03-7.01，=0.043）。
局部晚期胃癌患者围手术期血清 IL6 和 TNF 水平升高与 5 年生存结局呈负相关，表明围手术期抗炎治疗可能带来生存获益。
