Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Eur J Surg Oncol. 2024 Sep;50(9):108530. doi: 10.1016/j.ejso.2024.108530. Epub 2024 Jul 4.
Several inflammatory markers have gained interest as prognostic factors for cancer. The aim of this study is to evaluate the inflammatory markers interleukin-6 (IL-6), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as predictive markers for aggressive behavior and early recurrences in primary, localized soft tissue sarcoma (STS).
115 STS patients were retrospectively reviewed. IL-6 and CRP blood levels, NLR and PLR were obtained prior to treatment. Early recurrence was defined as disease relapse (local or distant) within the first year after surgery. Cox regression analysis was used to identify prognostic factors for early recurrence.
IL-6 elevation was associated with a higher tumor grade, increased size, tumor necrosis and a higher mitotic count. NLR elevation was associated with a higher tumor grade, PLR elevation with a larger tumor size. Early recurrences were found in 24 patients (21 %). Univariable analysis revealed that tumor grade (p = 0.029), tumor size (p = 0.030, >10 cm vs < 5 cm), tumor depth (p = 0.036), necrosis on imaging (p = 0.008), mitotic count (p = 0.045, ≥20 mitoses vs 0-9 mitoses), and IL-6 level (p = 0.044) were associated with early recurrence. The factors age at diagnosis, tumor location, necrosis at pathology, (neo)adjuvant radio- or chemotherapy, resection margin, CRP level, NLR and PLR were not related to early disease recurrence.
Increased inflammatory markers in STS are associated with an aggressive phenotype. STS patients with elevation of IL-6 may be at risk for early disease recurrence.
几种炎症标志物已作为癌症的预后因素而受到关注。本研究旨在评估炎症标志物白细胞介素 6（IL-6）、C 反应蛋白（CRP）、中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）作为原发性局限性软组织肉瘤（STS）侵袭性行为和早期复发的预测标志物。
回顾性分析 115 例 STS 患者。在治疗前检测 IL-6 和 CRP 血液水平、NLR 和 PLR。早期复发定义为手术后 1 年内疾病复发（局部或远处）。Cox 回归分析用于确定早期复发的预后因素。
IL-6 升高与肿瘤分级较高、肿瘤体积增大、肿瘤坏死和有丝分裂计数增加有关。NLR 升高与肿瘤分级较高有关，PLR 升高与肿瘤体积较大有关。24 例患者（21%）发生早期复发。单变量分析显示，肿瘤分级（p=0.029）、肿瘤大小（p=0.030，>10cm 与<5cm）、肿瘤深度（p=0.036）、影像学上的坏死（p=0.008）、有丝分裂计数（p=0.045，≥20 次/10 个高倍镜视野与 0-9 次/10 个高倍镜视野）和 IL-6 水平（p=0.044）与早期复发有关。诊断时的年龄、肿瘤位置、病理上的坏死、（新）辅助放化疗、切缘、CRP 水平、NLR 和 PLR 与早期疾病复发无关。
STS 中炎症标志物的升高与侵袭性表型有关。IL-6 升高的 STS 患者可能有早期疾病复发的风险。
