Prognostic value of interleukin-6 and interleukin-6 receptor in organ-confined clear-cell renal cell carcinoma: a 5-year conditional cancer-specific survival analysis.
Prognostic value of interleukin-6 and interleukin-6 receptor in organ-confined clear-cell renal cell carcinoma: a 5-year conditional cancer-specific survival analysis.
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白细胞介素 6 和白细胞介素 6 受体在器官局限性透明细胞肾细胞癌中的预后价值：5 年条件癌症特异性生存分析
DOI：
10.1038/bjc.2015.379
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发表时间：
2015-12-01
影响因子：
8.8
通讯作者：
Xu J
中科院分区：
文献类型：
--
作者：
Fu Q;Chang Y;An H;Fu H;Zhu Y;Xu L;Zhang W;Xu J
白细胞介素-6（IL-6）是诱导转录急性和慢性炎症反应的主要细胞因子，最近被纳入作为局部透明细胞肾细胞癌（ccRCC）的复发预测标志。由于在长期实践中，初始风险因素的预后效果可能会下降，我们的目的是报告RCC患者的条件性癌症特异性生存期（CCSS），并评估IL-6及其受体（IL-6 R）的影响，以提供更多相关的预后信息。我们招募了180例组织学证实的局部ccRCC患者，他们在2001年至2004年期间接受了肾切除术，并提供了病理信息。5年CCSS被确定，并根据未来的预后因素分层。用常数考克斯回归分析和Harrell一致性指数评价模型的预测精度。IL-6和IL-6 R均阳性表达的器官局限性ccRCC患者术后2年的5年CCSS为52%，接近局部晚期患者（48%，P=0.564），明显低于IL-6或IL-6 R阴性表达的器官局限性患者（89%，P<0.001）。多变量分析证明IL-6和IL-6 R是调整人口统计学因素后的独立预测因子。在前5年内，在器官限制的ccRCC人群中，pT-IL-6-IL-6 R风险分层的一致性指数明显高于分期、大小、分级和坏死预后模型（0.724 vs 0.669，P=0.002）或UCLA综合分期系统（0.724 vs 0.642，P=0.007）。联合IL-6和IL-6 R共表达是器官局限性ccRCC患者的独立早期免疫学预后因素。
Interleukin-6 (IL-6) is the major cytokine that induces transcriptional acute and chronic inflammation responses, and was recently incorporated as a recurrence prognostication signature for localised clear-cell renal cell carcinoma (ccRCC). As the prognostic efficacy of initial risk factors may ebb during long-term practice, we aim to report conditional cancer-specific survival (CCSS) of RCC patients and evaluate the impact of IL-6 as well as its receptor (IL-6R) to offer more relevant prognostic information accounting for elapsing time. We enrolled 180 histologically proven localised ccRCC patients who underwent nephrectomy between 2001 and 2004 with available pathologic information. Five-year CCSS was determined and stratified by future prognostic factors. Constant Cox regression analysis and Harrell's concordance index were used to indicate the predictive accuracy of established models. The 5-year CCSS of organ-confined ccRCC patients with both IL-6- and IL-6R-positive expression was 52% at year 2 after surgery, which was close to locally advanced patients (48%, P=0.564) and was significantly poorer than organ-confined patients with IL-6- or IL-6R-negative expression (89%, P<0.001). Multivariate analyses proved IL-6 and IL-6R as independent predictors after adjusting for demographic factors. Concordance index of pT-IL-6-IL-6R risk stratification was markedly higher compared with the stage, size, grade and necrosis prognostic model (0.724 vs 0.669, P=0.002) or UCLA Integrated Staging System (0.724 vs 0.642, P=0.007) in organ-confined ccRCC population during the first 5 years. Combined IL-6 and IL-6R coexpression emerges as an independent early-stage immunologic prognostic factor for organ-confined ccRCC patients.