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Mide Kanserli Hastalarda Preoperatif Serum CRP ve IL-6’nın Prognostik Değeri

Year 2020, , 188 - 195, 31.12.2020
https://doi.org/10.20492/aeahtd.790344

Abstract

Amaç: İnterlökin-6 (IL-6) inflamasyon ve tümör oluşumunda anjiogenesiz yolaklarında rol oynar. C-reaktif protein (CRP) inflamasyon belirtecidir ve birçok kanserin progresyonuna eşlik etmektedir. Bu çalışmada, mide kanseri tanısı ile ameliyat edilen hastalarda preoperatif CRP ve IL-6 düzeylerinin prognoza etkisi araştırıldı.
Gereç ve Yöntem: Kliniğimizde mide kanseri tanısıyla elektif koşullarda ameliyat edilen 45 hasta çalışmaya dahil edildi. Hastaların demografik, histopatolojik ve klinik özellikleri değerlendirildi. Preoperatif dönemde alınan kan örneklerinde CRP ve IL-6 düzeyleri çalışıldı.
Bulgular: IL-6 düzeyinin tanıdaki metastaz, mortalite ve CRP düzeyi ile anlamlı ilişkisi saptandı. CRP düzeyine etki eden faktörler ise, uzak metastaz, mortalite, CEA ve IL-6 olarak belirlendi. Multivaryant analizde CRP yüksekliğinin IL-6 düzeyini başka faktörlerden bağımsız olarak artırdığı saptandı. Hastalıksız sağkalımı etkileyen faktörler; CA 19-9, IL-6, CRP yüksekliği, kötü differensiyasyon, ileri tümör evresi, Lauren sınıflandırması, preoperatif metastaz varlığı olarak saptandı. IL-6, CRP, CEA yüksekliği, differensiyasyon, evre, duvar invazyon kalınlığı, Lauren sınıflamasında diffüz tip bulunması, lenfatik invazyon varlığı, preoperatif metastaz varlığı ve hastanın kemoterapi tedavisi alması toplam sağkalıma etki eden faktörler olarak saptandı. Nüks ve/veya metastaz gelişme riski; tanıda CRP değeri yüksek olan hastalarda 6.8 kat, hastalığa bağlı mortalite riski IL-6 değeri yüksek olan hastalarda 15.9 kat fazladır.
Sonuç: Mide kanserinde, preoperatif serum CRP ve IL-6 düzeylerinin ölçülmesi, hastalığın malignite potansiyelini ve progresyonunu yansıtır. Bu nedenle hastaların takibi ve tedaviye yanıtlarını monitörize etmede yararlı tümör belirteçleri olarak kullanılabilirler.

Supporting Institution

yok

Project Number

yok

References

  • 1. Roder JD, Böttcher K, Siewert JR, Busch R, Hermanek P, Meyer HJ. Prognostic factors in gastric carcinoma. Results of the German Gastric Carcinoma Study 1992. Cancer 1993;72(7):2089-97.
  • 2. Korenaga D, Haraguchi M, Okamura T, Baba H, Saito A, Sugimachi K. DNA ploidy and tumor invasion in human gastric cancer. Histopathologic differentiation. Arch Surg 1989;124(3):314-8.
  • 3. Moore JR. Gastric carcinoma: 30-year review. Can J Surg 1986;29(1):25-8.
  • 4. Layke JC, Lopez PP. Gastric cancer: diagnosis and treatment options. Am Fam Physicians 2004;69(5):1133-40.
  • 5. Bollschweiler E, Boettcher K, Hoelscher AH, Sasako M, Kinoshita T, Maruyama K, et al. Is the pronosis for Japanese and German patients with gasrtric carcinoma really different? Cancer 1993;71(10):2918-25
  • 6. Haugstvedt TK, Viste A, Eide GE, Söreide O. Norwegian multicenter study of survival and prognostic factors in patients undergoing curative resection for gastric carcinoma. Norwegian Stomach Cancer Trial. Br J Surg 1993;80(4):475-8.
  • 7. Yokota T, Kunii Y, Saito T, Teshima Y, Yamada Y, Takahashi M, et al. Prognostic factors for gastric cancer in the elderly. Eur J Surg Oncol 2001;27(5):451-53.
  • 8. Moriguchi S, Hayashi Y, Nose Y, Maehara Y, Korenaga D, Sugimachi K. A comparison of the logistic regression and the Cox proportional hazard models in retrospective studies on the prognosis of patients with gastric cancer. J Surg Oncol 1993;52(1):9-13.
  • 9. Kim JP, Kwon OJ, Oh ST, Yang HK. Results of surgery on 6589 gastric cancer patients and immunochemosurgery as the best treatment of advanced gastric cancer. Ann Surg 1992;216(3):269-79.
  • 10. Guggenheim DE, Shah MA. Gastric cancer epidemiology and risk factors. J Surg Oncol 2013;107(3):230-236.
  • 11. den Hoed CM, Kuipers EJ. Gastric Cancer: How Can We Reduce the Incidence of this Disease?. Curr Gastroenterol Rep 2016;18(7):34.
  • 12. Korenaga D, Moriguchi S, Orita H, Kakeji Y, Haraguchi M, Maehara Y, et al. Trends in survival rates in Japanese patients with advenced carcinoma of stomach. Surg Gynecol Obstet 1992;174:387-93.
  • 13. Lawrence W Jr, Menck HR, Steele GD Jr, Winchester DP. The National Cancer Data Base Report on gastric cancer. Cancer 1995;75(7):1734-44.
  • 14. Böttcher K, Becker K, Busch R, Roder JD, Siewert JR. Prognostic factors in stomach cancer. Results of a uni- and multivariate analysis. Chirurg 1992;63(8):656-61.
  • 15. Msika S, Chastang C, Houry S, Lacaine F, HuGuier M. Lymph node involvement as the only prognostic factor in curative resected gastric carcinoma: a multivariate analysis. World J Surg 1989;13(1):118-23.
  • 16. Okusa T, Nakane Y, Boku T, Takada H, Yamamura M, Hioki K, et al. Quantitative analysis of nodal involvement with respect to survival rate after curative gastrectomy for carcinoma. Surg Gynecol Obstet 1990;170(6):488-94.
  • 17. Siewert JR, Böttcher K, Roder JD, Busch R, Hermanek P, Meyer HJ. Prognostic relevance of systematic lymph node dissection in gastric carcinoma. German Gastric Carcinoma Study Group. Br J Surg 1993;80(8):1015-18.
  • 18. Gall FP, Hermanek P. Systematic lymph node dissection in curative therapy of stomach cancer. Chirurg 1993;64(12):1024-31. 19. Compan AF, Medrano J, Calpena R, Diego M, Lacueva J, Serrano P, et al. Gastric carcinoma: study of the most eminent prognostic factors. Eur J Surg Oncol 1993;19(6):533-8.
  • 20. Hermanek P. Prognostic factors in stomach cancer surgery. Eur J Surg Oncol 1986;12(3):241-6.
  • 21. Steälä LP, Kosma VM, Marin S, Lipponen PK, Eskelinen MJ, Syrjänen KJ, et al. Prognostic factors in gastric cancer: the value of vasculer invasion, mitotic rate and lymphoplasmacytic infiltration. Br J Cancer 1996;74(5):766-72.
  • 22. Gabbert HE, Meier S, Gerharz CD, Hommel G. Tumor-cell dissociation at the invasive front: a new prognostic parameter in gastric cancer patients. Int J Cancer 1992;50(2):202-7.
  • 23. Nakane Y, Okamura S, Akehira K, Boku T, Okusa T, Tanaka K, et al. Correlation of preoperative carcinoembryonic antigen levels and prognosis of gastric cancer patients. Cancer 1994;73(11):2703-8.
  • 24. Heiss MM, Babic R, Allgayer H, Gruetzner KU, Jauch KW, Loehrs U, et al. Tumor -associated proteolysis and prognosis: new functional risk factors in gastric cancer defined by the urokinase-type plasminogen activator system. J Clin Oncol 1995;13(8):2084-93.
  • 25. Lisborg P, Jatzko G, Horn M, Neumann HJ, Müller M, Stettner H, et al. Radical surgery (R2 resection) for gastric cancer. A multivariate analysis. Scand J Gastroenterol 1994;29(11):1024-28.
  • 26. Kubota T. New chemotherapy strategies for gastric cancer. In Vivo 2008;22(3):273-8.
  • 27. Sasako M, Sakuramoto S, Katai H, Kinoshita T, Furukawa H, Yayaguchi T, et al. Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol 2011;29(33):4387-93.
  • 28. Plukker JT, Mulder NH, Sleijfer DT, Grond J, Verschueren RC. Chemotherapy and surgery for locally advanced cancer of the cardia and fundus: phase II to study with methotrexate and 5-fluouracil. Br J Surg 1991;78(8):955-8.
  • 29. Gaspar MJ, Arribas I, Coca MC, Diez-Alonso M. Prognostic value of carcinoembryonic antigen, CA 19-9 and CA 72-4 in gastric carcinoma. Tumor Biol 2001;22(5):318-322.
  • 30. De Vita F, Romano C, Orditura M, Galizia G, Martinelli E, Lieto E, et al. Interleukin-6 serum correlates with survival in advanced gastrointestinal cancer patients but is not an independent ptognostic indicator. J Interferon Cytokine Res 2001;21(1):45-52. 31. Komoda H, Tanaka Y, Honda M, Matsuo Y, Hazama K, Takao T. Interleukin-6 levels in colorectal cancer tissues. World J Surg 1998;22(8):895-8.
  • 32. Łukaszewicz-Zajac M, Mroczko B, Szmitkowski M. Rola interleukiny 6 oraz białka C-reaktywnego w raku zoładka [The role of interleukin-6 and C-reactive protein in gastric cancer]. Pol Merkur Lekarski 2010;29(174):382-386.
  • 33. Kim DK, Oh SY, Kwon HC, Lee S, Kwon KA, Kim BG, et al. Clinical significances of preoperative serum interleukin-6 and C-reactive protein level in operable gastric cancer. BMC Cancer 2009 May 20;9:155.
  • 34. Guo J, Chen S, Chen Y, Li S, Xu D. Combination of CRP and NLR: a better predictor of postoperative survival in patients with gastric cancer. Cancer Manag Res 2018;10:315-321.
  • 35. Nozoe T, Iguchi T, Adachi E, Matsukuma A, Ezaki T. Preoperative elevation of serum C-reactive protein as an independent prognostic indicator for gastric cancer. Surg Today 2011;41(4):510-513.
  • 36. Shrotriya S, Walsh D, Bennani-Baiti N, Thomas S, Lorton C. C-Reactive Protein Is an Important Biomarker for Prognosis Tumor Recurrence and Treatment Response in Adult Solid Tumors: A Systematic Review. PLoS One 2015;10(12):e0143080.
  • 37. Jiang X, Hiki N, Nunobe S, Kumagai K, Kubota T, Aikou S, et al. Prognostic importance of the inflammation-based Glasgow prognostic score in patients with gastric cancer. Br J Cancer 2012 Jul 10;107(2):275-9.
  • 38. Ashizawa T, Okada R, Suzuki Y, Takagi M, Yamazaki T, Sumi T, et al. Clinical significance of interleukin-6 (IL-6) in the spread of gastric cancer: role of IL-6 as a prognostic factor. Gastric Cancer 2005;8(2):124-31. 39. Wu CW, Wang SR, Chao MF, Wu TC, Lui WY, P’eng FK, et al. Serum interleukin-6 levels reflect disease status of gastric cancer. Am J Gastroenterol 1996;91(7):1417-22.
  • 40. Kim HK, Song KS, Park YS, Kang YH, Lee YJ, Lee KR, et al. Elevated levels of circulating platelet microparticles, VEGF, IL-6 and RANTES in patients with gastric cancer: possible role of a metastasis predictor. Eur J Cancer 2003;39(2):184-91.
  • 41. de Mello J, Struthers L, Turner R, Cooper EH, Giles GR. Multivariate analyses as aids to diagnosis and assessment of prognosis in gastrointestinal cancer. Br J Cancer 1983;48(3):341-8.
  • 42. Fujita T, Hara A, Yamazaki Y. The value of acute phase protein measurements after curative gastric cancer surgery. Arch Surg 1999;134(1):73-5.

Prognostic Value of Preoperative CRP and IL-6 Levels in Gastric Carcinoma Patients

Year 2020, , 188 - 195, 31.12.2020
https://doi.org/10.20492/aeahtd.790344

Abstract

Objective: Interleukin-6 (IL-6) plays a role in pathways in inflammation and angiogenesis in tumor formation. C-reactive protein (CRP) is a marker of inflamation and accompanies the progression of many cancers.In this study, the effect of preoperative CRP and IL-6 levels on the prognosis of patients with gastric cancer was investigated.
Materials and Methods: Forty-five patients who underwent elective surgery for gastric cancer in our clinic between January 2002 and April 2004 were included in the study. Demographic, histopathological and clinical characteristics of the patients were evaluated. CRP and IL-6 levels were measured in preoperative blood samples.
Results: IL-6 levels were significantly correlated with preoperative metastasis, mortality, and CRP levels. Factors affecting CRP levels were preoperative and postoperative metastasis, mortality, CEA, and IL-6. Multivariate analysis showed that CRP elevation increased IL-6 levels independently of other factors. Factors affecting disease-free survival were; CA 19-9, IL-6, CRP, differentiation, tumor stage, Lauren classification, and presence of preoperative metastasis. Factors affecting total survival were; IL-6, CRP, CEA elevation, differentiation, stage, wall invasion thickness, presence of diffuse type in Lauren classification, presence of lymphatic invasion, presence of preoperative metastasis, and chemotherapy treatment.
Conclusion: Measurement of preoperative serum CRP and IL-6 levels in gastric cancer reflects the malignant potential and progression of the disease. Therefore, they can be used as useful tumor markers in monitoring patients and monitoring their response to treatment.

Project Number

yok

References

  • 1. Roder JD, Böttcher K, Siewert JR, Busch R, Hermanek P, Meyer HJ. Prognostic factors in gastric carcinoma. Results of the German Gastric Carcinoma Study 1992. Cancer 1993;72(7):2089-97.
  • 2. Korenaga D, Haraguchi M, Okamura T, Baba H, Saito A, Sugimachi K. DNA ploidy and tumor invasion in human gastric cancer. Histopathologic differentiation. Arch Surg 1989;124(3):314-8.
  • 3. Moore JR. Gastric carcinoma: 30-year review. Can J Surg 1986;29(1):25-8.
  • 4. Layke JC, Lopez PP. Gastric cancer: diagnosis and treatment options. Am Fam Physicians 2004;69(5):1133-40.
  • 5. Bollschweiler E, Boettcher K, Hoelscher AH, Sasako M, Kinoshita T, Maruyama K, et al. Is the pronosis for Japanese and German patients with gasrtric carcinoma really different? Cancer 1993;71(10):2918-25
  • 6. Haugstvedt TK, Viste A, Eide GE, Söreide O. Norwegian multicenter study of survival and prognostic factors in patients undergoing curative resection for gastric carcinoma. Norwegian Stomach Cancer Trial. Br J Surg 1993;80(4):475-8.
  • 7. Yokota T, Kunii Y, Saito T, Teshima Y, Yamada Y, Takahashi M, et al. Prognostic factors for gastric cancer in the elderly. Eur J Surg Oncol 2001;27(5):451-53.
  • 8. Moriguchi S, Hayashi Y, Nose Y, Maehara Y, Korenaga D, Sugimachi K. A comparison of the logistic regression and the Cox proportional hazard models in retrospective studies on the prognosis of patients with gastric cancer. J Surg Oncol 1993;52(1):9-13.
  • 9. Kim JP, Kwon OJ, Oh ST, Yang HK. Results of surgery on 6589 gastric cancer patients and immunochemosurgery as the best treatment of advanced gastric cancer. Ann Surg 1992;216(3):269-79.
  • 10. Guggenheim DE, Shah MA. Gastric cancer epidemiology and risk factors. J Surg Oncol 2013;107(3):230-236.
  • 11. den Hoed CM, Kuipers EJ. Gastric Cancer: How Can We Reduce the Incidence of this Disease?. Curr Gastroenterol Rep 2016;18(7):34.
  • 12. Korenaga D, Moriguchi S, Orita H, Kakeji Y, Haraguchi M, Maehara Y, et al. Trends in survival rates in Japanese patients with advenced carcinoma of stomach. Surg Gynecol Obstet 1992;174:387-93.
  • 13. Lawrence W Jr, Menck HR, Steele GD Jr, Winchester DP. The National Cancer Data Base Report on gastric cancer. Cancer 1995;75(7):1734-44.
  • 14. Böttcher K, Becker K, Busch R, Roder JD, Siewert JR. Prognostic factors in stomach cancer. Results of a uni- and multivariate analysis. Chirurg 1992;63(8):656-61.
  • 15. Msika S, Chastang C, Houry S, Lacaine F, HuGuier M. Lymph node involvement as the only prognostic factor in curative resected gastric carcinoma: a multivariate analysis. World J Surg 1989;13(1):118-23.
  • 16. Okusa T, Nakane Y, Boku T, Takada H, Yamamura M, Hioki K, et al. Quantitative analysis of nodal involvement with respect to survival rate after curative gastrectomy for carcinoma. Surg Gynecol Obstet 1990;170(6):488-94.
  • 17. Siewert JR, Böttcher K, Roder JD, Busch R, Hermanek P, Meyer HJ. Prognostic relevance of systematic lymph node dissection in gastric carcinoma. German Gastric Carcinoma Study Group. Br J Surg 1993;80(8):1015-18.
  • 18. Gall FP, Hermanek P. Systematic lymph node dissection in curative therapy of stomach cancer. Chirurg 1993;64(12):1024-31. 19. Compan AF, Medrano J, Calpena R, Diego M, Lacueva J, Serrano P, et al. Gastric carcinoma: study of the most eminent prognostic factors. Eur J Surg Oncol 1993;19(6):533-8.
  • 20. Hermanek P. Prognostic factors in stomach cancer surgery. Eur J Surg Oncol 1986;12(3):241-6.
  • 21. Steälä LP, Kosma VM, Marin S, Lipponen PK, Eskelinen MJ, Syrjänen KJ, et al. Prognostic factors in gastric cancer: the value of vasculer invasion, mitotic rate and lymphoplasmacytic infiltration. Br J Cancer 1996;74(5):766-72.
  • 22. Gabbert HE, Meier S, Gerharz CD, Hommel G. Tumor-cell dissociation at the invasive front: a new prognostic parameter in gastric cancer patients. Int J Cancer 1992;50(2):202-7.
  • 23. Nakane Y, Okamura S, Akehira K, Boku T, Okusa T, Tanaka K, et al. Correlation of preoperative carcinoembryonic antigen levels and prognosis of gastric cancer patients. Cancer 1994;73(11):2703-8.
  • 24. Heiss MM, Babic R, Allgayer H, Gruetzner KU, Jauch KW, Loehrs U, et al. Tumor -associated proteolysis and prognosis: new functional risk factors in gastric cancer defined by the urokinase-type plasminogen activator system. J Clin Oncol 1995;13(8):2084-93.
  • 25. Lisborg P, Jatzko G, Horn M, Neumann HJ, Müller M, Stettner H, et al. Radical surgery (R2 resection) for gastric cancer. A multivariate analysis. Scand J Gastroenterol 1994;29(11):1024-28.
  • 26. Kubota T. New chemotherapy strategies for gastric cancer. In Vivo 2008;22(3):273-8.
  • 27. Sasako M, Sakuramoto S, Katai H, Kinoshita T, Furukawa H, Yayaguchi T, et al. Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol 2011;29(33):4387-93.
  • 28. Plukker JT, Mulder NH, Sleijfer DT, Grond J, Verschueren RC. Chemotherapy and surgery for locally advanced cancer of the cardia and fundus: phase II to study with methotrexate and 5-fluouracil. Br J Surg 1991;78(8):955-8.
  • 29. Gaspar MJ, Arribas I, Coca MC, Diez-Alonso M. Prognostic value of carcinoembryonic antigen, CA 19-9 and CA 72-4 in gastric carcinoma. Tumor Biol 2001;22(5):318-322.
  • 30. De Vita F, Romano C, Orditura M, Galizia G, Martinelli E, Lieto E, et al. Interleukin-6 serum correlates with survival in advanced gastrointestinal cancer patients but is not an independent ptognostic indicator. J Interferon Cytokine Res 2001;21(1):45-52. 31. Komoda H, Tanaka Y, Honda M, Matsuo Y, Hazama K, Takao T. Interleukin-6 levels in colorectal cancer tissues. World J Surg 1998;22(8):895-8.
  • 32. Łukaszewicz-Zajac M, Mroczko B, Szmitkowski M. Rola interleukiny 6 oraz białka C-reaktywnego w raku zoładka [The role of interleukin-6 and C-reactive protein in gastric cancer]. Pol Merkur Lekarski 2010;29(174):382-386.
  • 33. Kim DK, Oh SY, Kwon HC, Lee S, Kwon KA, Kim BG, et al. Clinical significances of preoperative serum interleukin-6 and C-reactive protein level in operable gastric cancer. BMC Cancer 2009 May 20;9:155.
  • 34. Guo J, Chen S, Chen Y, Li S, Xu D. Combination of CRP and NLR: a better predictor of postoperative survival in patients with gastric cancer. Cancer Manag Res 2018;10:315-321.
  • 35. Nozoe T, Iguchi T, Adachi E, Matsukuma A, Ezaki T. Preoperative elevation of serum C-reactive protein as an independent prognostic indicator for gastric cancer. Surg Today 2011;41(4):510-513.
  • 36. Shrotriya S, Walsh D, Bennani-Baiti N, Thomas S, Lorton C. C-Reactive Protein Is an Important Biomarker for Prognosis Tumor Recurrence and Treatment Response in Adult Solid Tumors: A Systematic Review. PLoS One 2015;10(12):e0143080.
  • 37. Jiang X, Hiki N, Nunobe S, Kumagai K, Kubota T, Aikou S, et al. Prognostic importance of the inflammation-based Glasgow prognostic score in patients with gastric cancer. Br J Cancer 2012 Jul 10;107(2):275-9.
  • 38. Ashizawa T, Okada R, Suzuki Y, Takagi M, Yamazaki T, Sumi T, et al. Clinical significance of interleukin-6 (IL-6) in the spread of gastric cancer: role of IL-6 as a prognostic factor. Gastric Cancer 2005;8(2):124-31. 39. Wu CW, Wang SR, Chao MF, Wu TC, Lui WY, P’eng FK, et al. Serum interleukin-6 levels reflect disease status of gastric cancer. Am J Gastroenterol 1996;91(7):1417-22.
  • 40. Kim HK, Song KS, Park YS, Kang YH, Lee YJ, Lee KR, et al. Elevated levels of circulating platelet microparticles, VEGF, IL-6 and RANTES in patients with gastric cancer: possible role of a metastasis predictor. Eur J Cancer 2003;39(2):184-91.
  • 41. de Mello J, Struthers L, Turner R, Cooper EH, Giles GR. Multivariate analyses as aids to diagnosis and assessment of prognosis in gastrointestinal cancer. Br J Cancer 1983;48(3):341-8.
  • 42. Fujita T, Hara A, Yamazaki Y. The value of acute phase protein measurements after curative gastric cancer surgery. Arch Surg 1999;134(1):73-5.
There are 39 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original research article
Authors

Buket Altun Özdemir 0000-0002-1043-8108

Havva Belma Koçer 0000-0002-9888-0661

Mustafa Balcı 0000-0003-2950-2074

Project Number yok
Publication Date December 31, 2020
Submission Date September 4, 2020
Published in Issue Year 2020

Cite

AMA Altun Özdemir B, Koçer HB, Balcı M. Mide Kanserli Hastalarda Preoperatif Serum CRP ve IL-6’nın Prognostik Değeri. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. December 2020;53(3):188-195. doi:10.20492/aeahtd.790344