Title: Prognostic significance of serum inflammatory markers for patients with nasopharyngeal carcinoma
Abstract:
Background and Purpose:
Nasopharyngeal carcinoma (NPC) is a squamous cell carcinoma arising from the epithelial lining of the nasopharynx. Inflammation has significant effects on the prognosis of NPC patients. The inflammatory reaction stimulated by cancer is beneficial to its growth, progression, and immunosuppression. This study aimed to study the prognosis value of baseline inflammatory cytokines on the survival outcomes for NPC patients, which might contribute to providing new strategies for the diagnosis and treatment of NPC
Patients and Methods:
We retrospectively collected pre and post treatment serum of 262 candidates who were all confirmed to be stage I to IVa nasopharyngeal cancer by pathological examination. All patients received radiotherapy and chemotherapy, and nimotuzumab was given during radiotherapy. We examined the concentrations of interleukin (IL)-1, IL-4, IL-6, IL-10, IL-13, IL-17, tumor necrosis factor (TNF)-α, Interferon gamma (IFN)-γ, transforming growth factor-beta (TGF) β, monocyte chemoattractant protein (Mcp)-1 in the serum by Cytometric Bead Array and analyze on progression-free survival (PFS) using the Cox regression model. Associations of those cytokines with clinical pathological factors, treatment response, and overall survival were analyzed
Results: The 5-year overall survival rate of the entire group of patients was 70.6% (185/262), and the 5-year disease-free survival rate was 64.9% (170/262). The levels of IL-1, IL-6, TNF-α and IFN-γ were significantly elevated in patients with NPC pretreatment compared post treatment. However, TGFβ were reduced in I-II stage NPC, but elevated in III-IVa stage NPC. Pretreatment serum levels of IL-1, IL-6, TNF-α were closely and independently associated with overall survival. Compared to patients with high IL-6 expression, those with low expression had less risk of death (hazard ratio (HR) = 0.31, 95% confidence interval (CI) 0.13–0.75, p = 0.009). Patients with high TNF-α expression had a more than 2-fold increase in risk of death than those with low levels (HR = 2.66, 95% CI 1.04–6.78, p = 0.041). Post treatment serum levels of IL 1β showed less response to treatment (hazard ratio (HR) = 0.69, 95% confidence interval (CI) 0.74–1.83, p = 0.026). All HRs were adjusted for age, sex, stage, histology, and treatment. Kaplan-Meier survival analysis showed similar survival differences between these three groups
Conclusion: High pre treatment serum IL 6 and high serum TNF-α concentrations was a significant specific predictor for high mortality rate. Increased post treatment serum levels of IL 1β indicated good therapeutic response and most probably a high survival rate
