手术治疗的乳腺癌、结直肠癌和前列腺癌患者围手术期炎症和血管生成细胞因子特征:临床意义。

Contemporaneous Perioperative Inflammatory and Angiogenic Cytokine Profiles of Surgical Breast, Colorectal, and Prostate Cancer Patients: Clinical Implications.

机构信息

Department of Biomedical & Molecular Sciences, Queen's University, Kingston, ON K7L 3N6, Canada.

Dermatology Residency Program, the Cumming School of Medicine, University of Calgary, Calgary, AB T2T 5C7, Canada.

出版信息

Cells. 2023 Dec 4;12(23):2767. doi: 10.3390/cells12232767.

Abstract

Surgery-induced tumor growth acceleration and synchronous metastatic growth promotion have been observed for decades. Surgery-induced wound healing, orchestrated through growth factors, chemokines, and cytokines, can negatively impact patients harboring residual or metastatic disease. We provide detailed clinical evidence of this process in surgical breast, prostate, and colorectal cancer patients. Plasma samples were analyzed from 68 cancer patients who had not received treatment before surgery or adjuvant therapy until at least four weeks post-surgery. The levels of plasma cytokines, chemokines, and growth factors were simultaneously quantified and profiled using multiplexed immunoassays for eight time points sampled per patient. The immunologic processes are induced immediately after surgery in patients, characterized by a drastic short-term shift in the expression levels of pro-inflammatory and angiogenic molecules and cytokines. A rapid and significant spike in circulating plasma levels of hepatocyte growth factor (HGF), interleukin-6 (IL-6), placental growth factor (PLGF), and matrix metalloproteinase-9 (MMP-9) after surgery was noted. The rise in these molecules was concomitant with a significant drop in transforming growth factor-β1 (TGF-β1), platelet-derived growth factor (PDGF-AB/BB), insulin-like growth factor-1 (IGF-1), and monocyte chemoattractant protein-2 (MCP-2). If not earlier, each plasma analyte was normalized to baseline levels within 1-2 weeks after surgery, suggesting that surgical intervention alone was responsible for these effects. The effects of surgical tumor removal on disrupting the pro-inflammatory and angiogenic plasma profiles of cancer patients provide evidence for potentiating malignant progression. Our findings indicate a narrow therapeutic window of opportunity after surgery to prevent disease recurrence.

摘要

几十年来,人们一直观察到手术引起的肿瘤生长加速和同步转移性生长促进。手术引起的伤口愈合,通过生长因子、趋化因子和细胞因子来协调,可能会对患有残留或转移性疾病的患者产生负面影响。我们为手术治疗的乳腺癌、前列腺癌和结直肠癌患者提供了这一过程的详细临床证据。从 68 名癌症患者中分析了血浆样本,这些患者在手术或辅助治疗前均未接受治疗,直至手术后至少四周。使用针对每位患者的 8 个时间点同时进行的多重免疫分析,对血浆细胞因子、趋化因子和生长因子的水平进行了同时定量和分析。手术后患者会立即发生免疫过程,其特征是促炎和血管生成分子和细胞因子的表达水平急剧短期变化。手术后,循环血浆中肝细胞生长因子(HGF)、白细胞介素-6(IL-6)、胎盘生长因子(PLGF)和基质金属蛋白酶-9(MMP-9)的水平迅速显著上升。这些分子的上升伴随着转化生长因子-β1(TGF-β1)、血小板衍生生长因子(PDGF-AB/BB)、胰岛素样生长因子-1(IGF-1)和单核细胞趋化蛋白-2(MCP-2)的显著下降。如果不是更早,每个血浆分析物在手术后 1-2 周内恢复到基线水平,这表明手术干预本身就是这些影响的原因。手术切除肿瘤对破坏癌症患者促炎和血管生成的血浆特征的影响为促进恶性进展提供了证据。我们的发现表明,手术后有一个狭窄的治疗机会窗口,可以防止疾病复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d124/10706122/34952216dcac/cells-12-02767-g001.jpg

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