High plasma CD40 ligand level is associated with more advanced stages and worse prognosis in colorectal cancer.
High plasma CD40 ligand level is associated with more advanced stages and worse prognosis in colorectal cancer.
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DOI：
10.12998/wjcc.v10.i13.4084
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发表时间：
2022-05-06
影响因子：
1.1
通讯作者：
中科院分区：
文献类型：
--
作者：
结直肠癌（CRC）通常与血小板计数升高（> 400 × 109/L）相关，称为血小板增多症。CD 40配体（CD 40 L）是肿瘤坏死因子家族的一员，在结直肠癌中的作用存在争议。循环中CD 40 L在结直肠癌中较高，但其与疾病分期、局部和远处转移的关系尚不清楚。虽然大部分循环CD 40 L是由血小板产生的，但以前没有研究调查其与CRC相关血小板增多症的关系。探讨CD 40 L在大肠癌预后预测中的作用及其与血小板增多的关系。共有106名CRC患者和50名年龄和性别匹配的对照受试者入组本研究。收集包括合并症和组织病理学数据在内的既往数据。在CRC诊断时以及手术切除肿瘤后1.5个月和至少6个月进行实验室测量。采用酶联免疫吸附法测定血浆CD 40 L和血小板生成素水平，采用电化学发光免疫法测定血浆白细胞介素6水平。患者随访于2021年1月31日终止。CRC患者的血浆CD 40 L倾向性较高，而血小板计数（P = 0.0479），白细胞介素-6（P = 0.0002）和血小板生成素（P = 0.0024）水平显著高于对照组。106例CRC患者中有12例（11.3%）有血小板增多症。CD 40 L在远处转移（P = 0.0055）和/或血小板增多（P = 0.0294）的存在下显著升高。CD 40 L与血小板计数（P = 0.0045）、白细胞介素-6（P = 0.0130）和血小板增多（P = 0.0155）相关。CD 40 L在CRC的病程中是恒定的，所有基线差异在整个研究中持续存在。术前和术后血小板计数、CD 40 L和白细胞介素-6水平升高与患者总体和疾病特异性生存率差相关。CD 40 L和白细胞介素-6对患者生存的负面影响仍然存在，即使在血小板增多分层后。CRC患者CD 40 L水平不随病程变化。CD 40 L水平与血小板计数、白细胞介素-6、血小板增多和远处转移密切相关。
Colorectal cancer (CRC) is often associated with elevated platelet count (> 400 × 109/L), known as thrombocytosis. The role of CD40 ligand (CD40L), a member of the tumor necrosis factor family, is controversial in CRC. Circulating CD40L is higher in CRC, but its relationship with disease staging and local and distant metastasis is not clear. Although most of the circulating CD40L is produced by platelets, no previous study investigated its relationship with CRC-related thrombocytosis. To investigate the role of CD40L to predict the outcome of CRC and its relation to thrombocytosis. A total of 106 CRC patients and 50 age and sex-matched control subjects were enrolled for the study. Anamnestic data including comorbidities and histopathological data were collected. Laboratory measurements were performed at the time of CRC diagnosis and 1.5 mo and at least 6 mo after the surgical removal of the tumor. Plasma CD40L and thrombopoietin were measured via enzyme-linked immunosorbent assay, while plasma interleukin-6 was measured via electrochemiluminescence immunoassay. Patient follow-ups were terminated on January 31, 2021. Plasma CD40L of CRC patients was tendentiously higher, while platelet count (P = 0.0479), interleukin-6 (P = 0.0002), and thrombopoietin (P = 0.0024) levels were significantly higher as opposed to the control subjects. Twelve of the 106 CRC patients (11.3%) had thrombocytosis. Significantly higher CD40L was found in the presence of distant metastases (P = 0.0055) and/or thrombocytosis (P = 0.0294). A connection was found between CD40L and platelet count (P = 0.0045), interleukin-6 (P = 0.0130), and thrombocytosis (P = 0.0155). CD40L was constant with the course of CRC, and all baseline differences persisted throughout the whole study. Both pre- and postoperative elevated platelet count, CD40L, and interleukin-6 level were associated with poor overall and disease-specific survival of patients. The negative effect of CD40L and interleukin-6 on patient survival remained even after the stratification by thrombocytosis. CD40L levels of CRC patients do not change with the course of the disease. The CD40L level is strongly correlated with platelet count, interleukin-6, thrombocytosis, and the presence of distant metastases.
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影响因子：
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作者：
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影响因子：
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通讯作者：
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