The clinical relationship between IL-6, immune microenvironment and malignant pleura effusion lung adenocarcinoma

• Main Authors: Yen-chien Lee, 李妍蒨
• Other Authors: Wu-chou Su
• Format: Others
• Language: en_US
• Published: 2009
• Online Access: http://ndltd.ncl.edu.tw/handle/62635533996146239573

碩士 === 國立成功大學 === 臨床醫學研究所 === 97 === Purpose Lung cancer is the leading cancer-related death in Taiwan and worldwide and NSCLC accounted about 85% of lung cancer. Among NSCLC patients, those with pleural effusion at the time of initial diagnosis accounted for 14.4%. IL-6 had been implicated to be the possible cause of malignant pleural effusion. Women in Taiwan with malignant pleural effusion are usually nonsmoker and the tissue type is usually of adenocarcinoma subtype. Elevated serum IL-6 has been implicated as poor prognosis. Cancer cells could express FoxP3. The relationships between IL-6 and FoxP3 are controversies. We wonder if there is relationship between malignant pleural effusion IL-6 level and the circulating IL-6 serum level. To clarify the possible role of serum IL-6 level and the generation of malignant pleural effusion, the study is designed. We hope the profile of immune cells in lung cancer tissue might predict overall survival. Also, the relationship between serum, pleural IL-6 levels and the clinical prognosis of the patients needed to be clarified. Method 67 eligible patients with malignant pleural effusion came to National Chung Kung University from 2001 August 2 to 2008 Jan 3 were selected. The patients had received pleural biopsy by thoracoscopy before treatment. Pleural effusion was collected during the diagnostic thoracoscopy. Biopsy tissues were stained by immunohistochemistry of FoxP3, CD8+ and CD4+. Clinical data were collected. Serum and pleural interleukin-6 was measured by ELISA. Kaplan-Meier methods had been used for univariate analysis. Multivariate analyses were done by the Cox proportional hazards regression model. Results In univariate analyses, high serum IL-6 levels (p=0.018), high WBC, high platelets counts (p=0.02), and short PFS (p<0.01) correlated significantly with a worse overall survival. No such relation were noted for pleural effusion IL-6 levels , pleural CD8+, pleural CD4+, and FoxP3. In multivariate analyses, a high number of white blood cells (p=0.005) and short progression free survival (p=0.001) were independent worse prognostic factors for overall survival. Conclusion High WBC, short PFS had been related to worse overall survival.