结直肠癌患者癌组织中IL-23表达水平与预后的相关性研究

  目的  探讨结直肠癌患者癌组织中IL-23表达水平与预后的关系。  方法  选取2015年1月1日—2016年12月31日于南阳市中心医院就诊的164例结直肠癌患者并采用免疫组化法检测癌组织中IL-23的表达，染色强度得分×阳性表达率得分为0~1分、2~3分、4~5分和≥6分时分别计为阴性、弱阳性、中度阳性和强阳性，将“中度和强度阳性”视为IL-23高表达，其余为IL-23低表达；纳入2019年1月1日—2019年12月31日南阳市中心医院70例结直肠癌患者(观察组)和35例健康者(对照组)，比较血清中IL-23表达的差异。影响因素和诊断效能用Cox风险比例模型和受试者操作特征曲线分析。  结果  癌组织中IL-23高表达119例，低表达45例，主要表达于胞浆中。淋巴结转移(N1~N2)、TNM分期(Ⅲ期)和IL-23表达水平(高表达)是CRC患者预后的独立危险因素(均P < 0.01)。结直肠癌观察组血清中IL-23表达显著高于对照组(t=12.173，P < 0.001)。IL-23诊断结直肠癌的AUC为0.935(95% CI:0.888~0.981)，截断值为36.195 ng/mL，诊断灵敏度和特异度为94.30%和80.00%。  结论  IL-23高表达与结直肠癌不良预后有关，可作为预测预后的一项血清学筛查标志物。 

Expression of interleukin-23 in carcinoma tissues and its relationship with clinical prognosis in patients with colorectal cancer

  Objective  To investigate the association between interleukin-23 (IL-23) and colorectal cancer.  Methods  A total of 164 patients with colorectal cancer from January 1, 2015, to December 31, 2016, in Nanyang Central Hospital were enrolled. The expression of IL-23 in the carcinoma tissues of patients with colorectal cancer was detected by immunohistochemical methods. In accordance with the staining intensity score and positive cell count score, the 0-1, 2-3, 4-5 and ≥6 scores were defined as negative, weak positive, moderate positive and strong positive, respectively. The high and low expression of IL-23 in the carcinoma tissues of colorectal cancer in paraffin-embedded section were regarded as "moderate to strong positive" and "negative to positive", respectively. Another 70 patients with colorectal cancer and 35 normal individuals between January 1, 2019, and December 31, 2019, were enrolled as independent verification samples and the difference in the IL-23 expression in the serum of the two groups was compared. The influencing factors of postoperative recurrence in patients with colorectal cancer were analysed by Cox regression model and the clinical efficacy of serum IL-23 expression levels in the diagnosis of colorectal cancer was analysed by receiver operating characteristic (ROC) curve.  Results  In all colorectal cancer patients, there were 119 cases with high expression of IL-23 and the remaing with low expression of IL-23. The IL-23 were mostly expressed in the cytoplasm of cells. The lymph node metastasis (N1-N2), TNM stage (stage Ⅲ) and IL-23 expression (high expression) were independent risk factors affecting the prognosis of patients with CRC (P < 0.01).Compared with the control group, the serum expression level of IL-23 in the colorectal cancer experimental group was significantly increased (t=12.173, P < 0.001). ROC curve results showed that the AUC of IL-23 in the diagnosis of colorectal cancer was 0.935 (95% CI: 0.888-0.981). When the cut-off value was 36.195 ng/mL, the diagnostic sensitivity and specificity were 94.30% and 80.00%, respectively.  Conclusion  High expression of IL-23 is significantly associated with poor prognosis in patients with colorectal cancer. IL-23 could be used as a serological marker of CRC.