结直肠癌患者血清IL-37水平及与临床病理特征的关系*

Serum IL-37 level in patients with colorectal cancer and its relationship with clinicopathological features and prognosis*

摘要:

目的?观察结直肠癌患者血浆白细胞介素-37（IL-37）水平及与临床病理特点及预后的关系，探讨血清IL-37在结直肠癌诊疗中的临床价值。方法?选取2017年1月—2019年1月在丽水市中心医院胃肠外科就诊的结直肠癌患者200例作为结直肠癌组，另取该院同期健康体检者200例作为对照组。采用酶联免疫吸附试验测定血清IL-37水平。结果?结直肠癌组血清IL-37水平低于对照组（P?<0.05）。结直肠癌不同临床分期患者血清IL-37水平比较，差异有统计学意义（P?<0.05），随着临床分期升高血清IL-37水平降低。临床分期高、有淋巴结转移、有远处转移、生存时间短的患者血清IL-37水平低于临床分期低、无淋巴结转移、无远处转移、生存时间长的患者（P?<0.05）。不同年龄、性别、肿瘤位置、肿瘤类型、浸润深度及分化程度患者血清IL-37水平比较，差异无统计学意义（P?>0.05）。Cox回归单因素分析显示，不同临床分期、淋巴结转移、远处转移及IL-37水平结直肠癌患者生存期比较，差异有统计学意义（P?<0.05）。多因素分析显示，临床分期[RlR=0.043（95% CI：0.014，0.102）]、淋巴结转移[RlR=0.038（95% CI：0.016，0.097）]、远处转移[RlR=0.049（95% CI：0.013，0.120）]和IL-37水平[RlR=0.067（95% CI：0.028，0.168）]是结直肠癌患者生存的影响因素。结论?结直肠癌患者血清IL-37水平降低，血清IL-37水平与结直肠癌患者的临床分期、淋巴结转移、远处转移和预后关系密切。

Abstract:

Objective?To observe the serum interleukin-37 (IL-37) level in patients with colorectal cancer and its relationship with clinicopathological features and prognosis in order to explore the clinical value of serum IL-37 in colorectal cancer.?Methods?A total of 200 patients with colorectal cancer seeking medical care in the Department of Gastrointestinal Surgery of Lishui Central Hospital from January 2017 to January 2019 were selected as the colorectal cancer group (CRC group) and 200 healthy subjects in the same period were selected as the control group (C group). The serum IL-37 levels were determined by enzyme-linked immunosorbent assay (ELISA).?Results?The serum IL-37 level in the CRC group was lower than that in the C group (P < 0.05). The serum IL-37 levels in patients with different TNM stages of colorectal cancer were statistically significant (F?=?46.046, P < 0.05), and the serum IL-37 levels decreased with the advance of TNM stages. The patients with high TNM stage, lymph node metastasis, distant metastasis and short survival time had lower serum IL-37 levels than those with low TNM stage, no lymph node metastasis, no distant metastasis and long survival time (P < 0.05). There were no significant differences in serum IL-37 levels among patients of different ages, genders and with distinct tumor location, tumor type, depth of tumor invasion and degree of tumor differentiation (P?>?0.05). The univariate Cox regression analysis showed that differences in survival of colorectal cancer patients with different TNM stages, lymph node metastasis, distant metastasis and IL-37 levels were statistically significant (P < 0.05). The multivariate analysis showed that TNM stage [RlR?=?0.043, (95% CI: 0.014, 0.102)], lymph node metastasis [RlR?=?0.038, (95% CI: 0.016, 0.097)], distant metastasis [RlR?=?0.049, (95% CI: 0.013, 0.120)] and IL-37 levels [RlR?=?0.067, (95% CI: 0.028, 0.168)] were independent factors for the survival of colorectal cancer patients (P < 0.05).?Conclusions?Serum IL-37 level is decreased in patients with colorectal cancer, and the serum IL-37 level is closely related to TNM stage, lymph node metastasis, distant metastasis and prognosis of colorectal cancer.