Predictive and prognostic value of inflammatory factors (IL-6, IL-8, and TNF-α) in saliva for radiotherapy response in patients with HPV-associated oropharyngeal squamous cell carcinoma.

OBJECTIVE

This investigation focused on analyzing saliva inflammatory factors (IL-6, IL-8, and TNF-α) to predict radiotherapy response and determine prognostic value in individuals with HPV-linked oropharyngeal squamous cell carcinoma (OPSCC).

METHODS

Sixty patients diagnosed with HPV-associated OPSCC and treated with 3D conformal intensity-modulated radiotherapy at our hospital from June 2016 to June 2020 were selected, as well as 60 healthy individuals who underwent outpatient physical exams as the control group. The relationship between saliva IL-6, IL-8, and TNF-α and clinicopathological features was analyzed. The relationship between HPV status and radiotherapy response in OPSCC patients was analyzed, and the predictive value of saliva inflammatory factors on radiotherapy response was analyzed by ROC curves, and the factors influencing the prognosis of OPSCC were analyzed by Cox regression.

RESULTS

Saliva IL-6, IL-8, and TNF-α in OPSCC patients did not show any statistically significant differences when analyzed across different genders, ages, tumor sites, histological grades, tumor sizes, clinical stages, cervical lymph node metastasis, and HPV status. IL-6, IL-8, and TNF-α in OPSCC patients were higher than those in healthy individuals. Patients with HPV-positive OPSCC were more sensitive to radiotherapy compared to those with HPV-negative. Saliva TNF-α levels were elevated in the radiotherapy-sensitive OPSCC patients, with IL-6 and IL-8 levels being lower than those in radiotherapy-insensitive patients. For predicting radiotherapy response, the AUC for IL-6, IL-8, and TNF-α was 0.744, 0.750, and 0.742, respectively, with the combination yielding an AUC of 0.821. Among OPSCC patients, those who survived showed higher TNF-α levels in saliva and lower IL-6 and IL-8 levels compared with those died. Elevated TNF-α level in saliva and sensitivity to radiotherapy were protective factors affecting prognosis, and elevated IL-6 and IL-8 were risk factors.

CONCLUSION

Saliva IL-6, IL-8, and TNF-α are related to radiotherapy sensitivity and prognosis in patients with HPV-associated OPSCC, which can guide the selection of clinical treatment programs.