| Objective:Detection of interleukin 6(IL-6),interleukin 10(IL-10),interferon γ(IFN-γ),interleukin 17(IL-17),interleukin 4(IL-4),interleukin 12p70(IL-12p70),and tumor necrosis factor-alpha(TNF-α)levels in peripheral blood of patients with locally advanced or advanced non-small cell lung cancer(NSCLC)by flow cytometry.To explore its relationship with the susceptibility to metastasis,disease progression,and chemotherapy efficacy in patients with NSCLC,so as to provide a basis for making individualized treatment decisions in clinical practice and improve the quality of life of patients.Methods:1)Information on clinical baseline and laboratory data of NSCLC patients w ho visited the Cancer Hospital affiliated to Anhui University of Science and Te chnology seen from May 2021-August 2022 were retrospectively analyzed.Patie nts were divided into two groups based on whether they had metastasis,and a comparison of the levels of seven inflammatory cytokines was made in both gr oups.Using univariate analysis to screen risk factors.The value of seven inflam matory cytokines were compared with Recombinant Cytokeratin Fragment Antige n 21.1(CYFRA21.1)according to the receiver operating characteristic curve(RO C).The diagnostic efficacy of cytokines in the population not recognized by C YFRA21.1 was further analyzed.2)A cross-sectional study was carried out on NSCLC patients who visited the Cancer Hospital during the above period,and 26 healthy subjects who had been examined at the same time were enrolled in the healthy control group.Detection of inflammatory cytokine levels by flow cytometry.Investigating the association of seven inflammatory cytokine levels with disease progression(including T,N,and M stages,PS scores,and the occurrence of pleural effusion)in patients with NSCLC.3)Clinical data of patients with NSCLC who received treatment in the Cancer Hospital and planned to receive first-line chemotherapy during the above period were collected.Patients’ data on seven inflammatory cytokine levels were measured using flow cytometry and and the content of cytokines before and after treatment was compared and analyzed.Also follow up and record the efficacy evaluation of patients after at least two cycles of treatment.Selection of risk factors using univariate analysis and analysis of their effect values by multiple regression adjusted models,and the corresponding linear relationship was further explored by smoothing curve fitting.Finally,ROC curve was used to evaluate the diagnostic efficacy of inflammatory cytokines.Result:1)Compared with the patients without metastasis,the levels of IL-6(p<0.001)and IL-10(p<0.001)in patients with metastasis were significantly higher.Furthermore,in the comparison of different metastasis conditions,patients with brain metastases were found to have significantly higher levels of IL-17 compared to those with bone metastases(p=0.031).The results of univariate analysis showed that IL-6 and IL-10 were risk factors for metastasis in NSCLC patients(p<0.05).That the ROC curve shows IL-6(AUC=0.820)was more effective than CYFRA21.1(AUC=0.688)in diagnosing metastasis in NSCLC patients.After screening out the population with CYFRA21.1 in the normal range but also with metastasis for ROC analysis,the diagnostic efficacy of four inflammatory cytokines is better than that of CYFRA21.1(IL-6: AUC=0.796,IL-10: AUC=0.673,IL-4: AUC=0.539,TNF-α: AUC=0.535,CYFRA21.1:0.534).2)Correlation analysis showed that IL-6 level in NSCLC patients was significantly positively correlated with T stage(r=0.204,p=0.003),PS score(r=0.441,p=0),M stage(r=0.281,p=0)and whether pleural effusion occurred(r=0.424,p=0).There was positive correlation between IL-10 and M stage(r=0.148,p=0.031),and TNF-α level and PS score were negatively correlated(r=-0.135,p=0.049).3)As of the last follow-up date in August 2022,IL-4(p<0.05),IL-12p70(p<0.05)and TNF-α(p<0.05)levels were significantly higher than baseline levels in patients in the partial remission(PR)group after two cycles of treatment,whereas IL-6 levels(p<0.01)in patients with disease stability/progression(SD/PD)was remarkably higher after two cycles of treatment than the baseline level.Comparing the different data of inflammatory cytokines before treatment in different curative groups,it was found that the levels of IL-6(p<0.001)and IL-10(p<0.01)in the SD/PD group were significantly increased compared with PR group.Univariate and multivariate analysis indicated that with the increase of IL-6 level,the risk of NSCLC patients not benefiting from chemotherapy increased by 16%(OR: 0.16,95% CI: 1.05-1.27,p=0.002),and showed a linear association between each of them.The ROC curve indicated an AUC=0.728 for IL-6 diagnostic efficacy evaluation,the best cut-off value was 6.515pg/ml,and performance values of 86.1% and 55.7% for specificity and sensitivity,respectively.Conclusion:1)Inflammatory cytokine levels are closely related to metastasis in patients with NSCLC.Compared with tumor marker CYFRA21.1,IL-6 has a higher AUC,and inflammatory cytokine also has diagnostic efficacy in people who cannot be distinguished by CYFRA21.1.2)Patients with NSCLC showed significant correlation between disease progression(T stage,M stage,PS score,occurrence of pleural effusion)and their inflammatory cytokines levels in peripheral blood.Patients with IL-6 levels higher than 5.335pg/ml had higher T-stage and PS scores and were more likely to develop metastasis and pleural effusion.Increased IL-10 levels also showed a significant positive correlation with the patient’s M stage,and the possibility of metastasis was higher when IL-10 was above 1.245pg/ml.The TNF-α was significantly negatively correlated with PS score.When the level of TNF-α was higher than 1.135pg/ml,the PS score was lower and the physical status was better.3)The use of a first-line chemotherapy regimen can effectively promote the beneficial changes in levels of IL-4,IL-12P70,and TNF-α in PR patients.The baseline serum IL-6 level of NSCLC patients has predictive value for whether they can benefit from first-line chemotherapy,and can distinguish between those who benefit from chemotherapy and those who do not.NSCLC patients with IL-6 level lower than6.515pg/ml are more likely to benefit from first-line chemotherapy.Figure [16] Table [14] Reference [59]... |
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