结直肠癌患者血清白细胞介素6水平及与肿瘤疗效关系

目的 探讨人白细胞介素6(interleukin-6,IL-6)在结直肠癌患者中的水平及意义.方法 收集132例首诊结直肠癌患者(CRC)、35例炎症性肠病(IBD)、31例肠道良性疾病患者(CBD)及84例健康体检者(HC)血清,采用电化学发光双抗体夹心免疫分析法(ECLIA)检测血清中白细胞介素6(IL-6)及癌胚抗原(CEA)水平,分析IL-6水平与结直肠癌患者临床病理特征的相关性;应用受试者工作特性曲线(ROC)和二元Logistic法回归分析IL-6和CEA两指标对结直肠癌的诊断价值;对随访资料完整的120例中晚期结直肠癌患者动态观察治疗前后血清IL-6和CEA水平,分析两指标与肿瘤疗效的关系.结果 结直肠癌患者血清IL-6水平显著高于炎症性肠病组(P＜0.05)、肠道良性疾病组(P＜0.01)和健康对照组(P＜0.01),结直肠癌患者血清CEA水平显著高于炎症性肠病组(P＜0.05)、肠道良性疾病组(P＜0.05)和健康对照组(P＜0.01),差异均有统计学意义.CRC患者血清IL-6水平与肿瘤直径、分化程度、组织类型、淋巴结转移、远处转移、TNM分期均显著相关(P＜0.05),而与年龄、性别及肿瘤发生部位无明显相关.IL-6诊断结直肠癌的灵敏度(72.7％)和准确性(78.6％)均高于CEA(分别为68.2％和77.9％),特异性(85.2％)低于CEA(88.9％),两指标联合检测能够提高灵敏度(97.2％)和准确性(85.6％).结直肠癌肿瘤控制组(CR +PR+SD)治疗后两指标均较治疗前有显著下降(P＜0.05),差异有统计学意义,而肿瘤进展组(PD)治疗后两指标均未显著下降(P＞0.05).结论 IL-6和CEA两指标联合检测有助于结直肠癌的诊断和疗效观察.

Serum Level of Interleukin-6 in Colorectal Cancer and the Correlation Between the Kinetics of Interleukin-6 Levels and the Tumor Curative Effect

Objective To investigate the expression of serum interleukin-6(IL-6) in colorectal cancer patients and the relationship between the IL-6 level and the tumor curative effect.Methods The electrochemiluminescence immunoassay was used to examine the serum level of IL-6 and carcino-embryonic antigen (CEA) in 132 colorectal cancer patients (CRC),35 inflammatory bowel disease (IBD),31 colorectal benign disease(CBD) and 84 healthy donors as healthy control group (HC).The relationship between IL-6 and clinicopathological features of colorectal cancer was analyzed,and ROC curve and binary losistic regression were applied to compare the diagnostic value of the IL-6 and CEA.The dynamic levels of serum IL-6 and CEA before and after treatment in 120 advanced CRC patients with complete case data was observed,and the relationship between IL-6 and CEA and the cruative effect of the tumor was analyzed.Results Both the serum IL-6 and CEA levels of the CRC were higher than IBD (P ＜ 0.05,P ＜ 0.05,respectively),CBD (P ＜ 0.01,P ＜ 0.05,respectively),and HC groups (P ＜ 0.01,P ＜ 0.01,respectively).Serum levels of the IL-6 was significantly correlated with tumor size,degree of tumor differentiation,pathological type,lymph node metastasis,distant metastasis and TNM stage (all the above,P ＜ 0.05).The sensitivity and accuracy of IL-6 for CRC diagnosis were higher than CEA (72.7％ vs 68.2％,78.6％ vs 77.9％,respectively),while specifity was lower than CEA(85.2％ vs 88.9％).The combined detection of IL-6 and CEA were highest in sensitivity (97.2％) and accuracy (85.6％).After treatment,both the serum IL-6 and CEA levels significantly decreased in CR + PR + SD group(both P ＜0.05),but not in the PD group (both P ＞ 0.05).Conclusion The combined detection of serum IL-6 and CEA could be a useful potential diagnostic and therapeutic evaluation method for colorectal cancer.