The relationship between the local and systemic inflammatory responses and survival in patients undergoing resection for localized renal cancer
The relationship between the local and systemic inflammatory responses and survival in patients undergoing resection for localized renal cancer
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DOI：
10.1111/j.1464-410x.2008.07666.x
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发表时间：
2008-09-01
影响因子：
4.5
通讯作者：
McMillan, Donald C.
中科院分区：
文献类型：
--
作者：
Lamb, Gavin W. A.;McArdle, Peter A.;McMillan, Donald C.
为了检查全身炎症反应与（C反应蛋白，CRP）、肿瘤白细胞介素-6受体和环氧合酶（考克斯）-2表达、肿瘤T淋巴细胞肾细胞癌（RCC）切除术患者的CD 4+、CD 8+浸润和癌症存活率，因为局部和全身的炎症反应似乎都能预测这些患者的预后。2这项研究包括了60名因局限性肾细胞癌而接受肾切除术的患者。术前测定循环CRP水平，肿瘤白细胞介素-6受体和考克斯-2表达，肿瘤CD 4+和CD 8 + T淋巴细胞采用免疫组化分析进行评估。中位随访时间为78个月，14例患者复发，9例癌症特异性死亡。在单变量和多变量生存分析中，肿瘤分期和分级以及CRP水平被确定为与无复发和癌症特异性生存相关的重要因素。Fuhrman分级与CD 4 + T淋巴细胞浸润呈正相关（P < 0.05）。肿瘤白细胞介素-6受体表达的增加与肿瘤CD 8 + T淋巴细胞浸润的增加弱相关（P = 0.057）。肿瘤组织中CD 4 + T淋巴细胞浸润的增加与CD 8 + T淋巴细胞浸润的增加相关（P < 0.01），提示肿瘤相关因素如IL-6受体和考克斯-2表达或T淋巴细胞亚群浸润在决定局限性肾癌患者生存的系统性因素如CRP水平方面是次要的。
To examine the relationship between the systemic inflammatory response (C-reactive protein, CRP), tumour interleukin-6 receptor and cyclooxygenase (COX)-2 expression, tumour T-lymphocytic (CD4+, CD8+) infiltration and cancer survival in patients undergoing resection for renal cell carcinoma (RCC), as both the local and systemic inflammatory responses appear to predict the outcome in these patients.The study included 60 patients undergoing nephrectomy for localized RCC. Pre-operative circulating CRP levels were measured and tumour interleukin-6 receptor and COX-2 expression, tumour CD4+ and CD8+ T lymphocytes were assessed using immunohistochemical analysis.The median follow-up was 78 months, with 14 patients relapsing from their disease and nine cancer-specific deaths. On univariate and multivariate survival analysis, tumour stage and grade and CRP levels were identified as significant factors associated with relapse-free and cancer-specific survival. There was a significant direct relationship between Fuhrman grade and CD4+ T-lymphocytic infiltrate (P < 0.05). An increase in tumour expression of interleukin-6 receptor was weakly associated with an increase in tumour CD8+ T-lymphocytic infiltration (P = 0.057). An increase in tumour CD4+ T-lymphocytic infiltration was associated with an increase in CD8+ T-lymphocytic infiltration (P < 0.01).The present results suggest that tumour-based factors such as interleukin-6 receptor and COX-2 expression or T-lymphocytic subset infiltration are subordinate to systemic factors such as CRP level in determining survival in patients with localized RCC.