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

Öz

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.

Anahtar Kelimeler

• Mide kanseri
• prognostik faktörler
• IL-6
• CRP

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

Öz

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.

Anahtar Kelimeler

• Gastric carcinoma
• Prognostic factors
• IL-6
• CRP

Kaynakça

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