Clinical significances of preoperative serum interleukin-6 and C-reactive protein level in operable gastric cancer

Abstract

BackgroundThe interleukin-6 (IL-6) pathway is one of the mechanisms that link inflammation and angiogenesis to malignancy. Because the C-reactive protein (CRP) is a representative marker for inflammation, CRP has recently been associated with the progression of disease in many cancer types. The principal objective of this study was to determine the preoperative serum levels of IL-6 and CRP in gastric carcinoma, and to correlate them with disease status and prognosis.MethodsA total of 115 patients who underwent gastrectomy were enrolled in this study. Serum levels of IL-6 were assessed via Enzyme-Linked Immuno-Sorbent Assay (ELISA), and CRP was measured via immunoturbidimetry. Histological findings included tumor size, depth of tumor invasion, lymph node (LN) metastasis, and TNM stage (6th AJCC Stage Groupings: The staging systems; Primary tumor, regional LN, metastasis).ResultsIncreases in cancer invasion and staging are generally associated with increases in preoperative serum IL-6 levels. IL-6 and CRP levels were correlated with invasion depth (P < 0.001, P = 0.001), LN metastasis (P < 0.001, P = 0.024) and TNM stage (P < 0.001, P < 0.001). The presence of peritoneal seeding metastasis is associated with IL-6 levels (P = 0.012). When we established the cutoff value for IL-6 level (6.77 pg/dL) by ROC curve, we noted significant differences in time to progression (TTP; P < 0.001) and overall survival (OS; P = 0.010). However, CRP evidenced no significance with regard to patients' TTP and OS levels. Serum IL-6 levels were correlated positively with CRP levels (r2 = 0.049, P = 0.018).ConclusionPreoperative serum IL-6 and CRP levels might be markers of tumor invasion, LN metastasis, and TNM stage. Preoperative high IL-6 levels were proposed as a poor prognostic factor for disease recurrence and overall survival in patients with gastric cancers.

Levels of acute inflammatory biomarkers in advanced prostate cancer patients with α2-macroglobulin deficiency

“…It has been shown that serum IL-6 and CRP levels may be useful in the differentiation between diagnosis of pancreatic cancer and chronic pancreatitis (22). Kim et al reported that preoperative serum IL-6 and CRP levels may be markers of tumor invasion, lymph node metastasis and TNM stage (23). In the present study, CRP, SAA and IL-6 levels in serum were significantly increased in PCa patients without α2M deficiency as compared with healthy controls and PCa patients with α2M deficiency.…”

Clinical significance of pre-operative neutrophil lymphocyte ratio and platelet lymphocyte ratio as prognostic factors for patients with colorectal cancer

“…CRP is an index of systemic inflammation and has been identified as a prognostic factor in patients with CRC and gastric cancer (24,25). However, serum CRP levels are not routinely assessed in the pre-operative assessment (12,14,18).…”

Assessment of platelet activation and phagocytic activity in gastric cancer patients

“…Due to its pyrogenic action, IL-6 is responsible for cachexia, fever, body mass reduction and other devastating symptoms of tumor progression. Determination of IL-6 can be a prognostic factor of survival in gastric cancer patients [19][20][21] . In our study, the level of IL-6 was found to increase in all gastric cancer patients.…”