探讨血清炎症标志物白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)对前列腺癌(PCa)患者行前列腺癌根治术(RP)后Gleason评分(GS)变化的影响。我们进行了这项研究。
从2012年11月到2021年9月,共有237名患者在我们机构接受了RP。手术前1周内收集所有患者的血样。术前临床特征包括年龄,血清IL-6和TNF-α,中性粒细胞与淋巴细胞的比率,C反应蛋白,血小板与淋巴细胞的比率,淋巴细胞与单核细胞的比率,全身免疫炎症指数,前列腺影像学报告和数据系统(PI-RADS)评分,前列腺特异性抗原,和活检GS进行评估。采用单因素和多因素logistic回归分析确定RP后GS变化的危险因素。该预测模型的效率通过接收器工作特性曲线的曲线下面积来确定。
在整个队列中,73例患者(30.8%)的GS升高,55例患者(23.2%)GS降级.在比较有和没有GS升级的PCa患者时,多因素logistic回归分析显示,血清TNF-α(比值比[OR]:2.518,p=0.019)和IL-6(OR:0.478,p=0.023)是GS发生的独立预测因素。我们还比较了GS升级和GS降级的患者的特征;多因素logistic回归分析也显示了这两组之间血清IL-6和TNF-α的显着差异(均p<0.05)。此外,在多变量分析中,我们发现低前列腺体积和活检GS≥7与较高PI-RADS溃疡显著相关.
PCa患者血清TNF-α高表达与GS升高呈正相关。PCa患者血清IL-6高表达水平与GS升高呈负相关,与GS降低呈正相关。
To study the effect of inflammatory markers in blood such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) on the Gleason score (GS) changes in patients with prostate cancer (PCa) after radical prostatectomy (RP), we conducted this study.
From November 2012 to September 2021, a total of 237 patients underwent RP at our institution. Blood samples from all patients were collected within 1 week before surgery. Preoperative clinical characteristics include age, serum IL-6 and TNF-α, neutrophil-to-lymphocyte ratio, C-reactive protein, the platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, systemic immune-inflammation index, the prostate imaging reporting and data system (PI-RADS) score, prostate-specific antigen, and biopsy GS were assessed. Univariate and multivariate logistic regression analyzes were used to determine the risk factors of GS changes after RP. The efficiency of this prediction model was identified with the area under the curve of the receiver operating characteristic curve.
Seventy-three patients (30.8%) had GS upgraded in the overall cohort, and 55 patients (23.2%) had GS downgraded. In comparing PCa patients with and without GS upgraded, multivariate logistic regression analysis showed that serum TNF-α (odds ratio [OR]: 2.518, p = 0.019) and IL-6 (OR: 0.478, p = 0.023) were independent factors predicting the occurrence of GS
upgrade. We also compared the characteristics of patients with GS upgraded and GS downgraded; multivariate logistic regression analysis also demonstrated significant differences in serum IL-6 and TNF-α between these two groups (all p < 0.05). In addition, we found that low prostate volume and biopsy GS ≥ 7 were significantly associated with higher PI-RADS sores in multivariate analysis.
The high expression of serum TNF-α level is positively correlated with GS upgraded in PCa patients. High expression of serum IL-6 level is negatively correlated with GS upgraded in PCa patients and positively related with GS downgraded.