结直肠癌患者血清IL-26、IL-27水平检测的临床意义

doi:10.3969/j.issn.1673-8640.2024.01.002

摘要/Abstract

摘要：

目的探讨结直肠癌患者血清白细胞介素（IL）26、IL-27水平检测的临床意义。方法选取2018年5月—2021年5月汉中市三二〇一医院结直肠癌患者63例（结直肠癌组）、直肠息肉患者63例（直肠息肉组）、体检健康者63名（正常对照组），检测IL-26、IL-27、癌胚抗原（CEA）、糖类抗原19-9（CA19-9）水平。收集所有研究对象的一般资料和结直肠癌患者的临床病理资料。采用受试者工作特征（ROC）曲线评价各项指标辅助诊断结直肠癌的效能。对所有结直肠癌患者随访3年，采用Kaplan-Meier生存曲线评估结直肠癌患者的生存情况。结果结直肠癌组、直肠息肉组和正常对照组血清IL-26、IL-27水平依次升高（P<0.001）。有无淋巴转移、不同TNM分期、不同分化程度的结直肠癌患者之间血清IL-26、IL-27水平差异均有统计学意义（P<0.05），不同年龄、不同性别、有无远隔转移、不同病理类型、不同肿瘤大小的结直肠癌患者之间血清IL-26、IL-27水平差异均无统计学意义（P>0.05）。ROC曲线分析结果显示，IL-26、IL-27、CEA和CA19-9单项检测和联合检测诊断结直肠癌的曲线下面积（AUC）分别为0.82、0.86、0.81、0.82、0.92。根据ROC曲线得出的最佳临界值将结直肠癌患者分别分为IL-26高水平组（41例）、IL-26低水平组（22例）和IL-27高水平组（43例）、IL-27低水平组（20例）。Kaplan-Meier生存曲线分析结果显示，IL-26高水平组和IL-27高水平组的无进展生存期分别短于IL-26低水平组和IL-27低水平组（P<0.01）。结论结直肠癌患者血清IL-26、IL-27水平异常升高，与肿瘤标志物联合检测可用于结直肠癌的辅助诊断和预后评估。

关键词: 白细胞介素26, 白细胞介素27, 癌胚抗原, 糖类抗原19-9, 结直肠癌, 预后

Abstract:

Objective To investigate the roles of serum interleukin（IL）-26 and IL-27 levels in patients with colorectal cancer. Methods A total of 63 patients with colorectal cancer（colorectal cancer group），63 patients with rectal polyps（rectal polyp group） and 63 healthy subjects（healthy control group） were enrolled from Hanzhong No. 3201 Hospital from May 2018 to May 2021. The levels of IL-26，IL-27，carcinoembryonic antigen（CEA） and carbohydrate antigen 19-9（CA19-9） were determined. The general data and clinical pathological data were collected. The efficacy of each indicator for the diagnosis of colorectal cancer was evaluated by receiver operating characteristic（ROC） curve. All the patients with colorectal cancer were followed up for 3 years，and the survival status was assessed by Kaplan-Meier survival curve. Results Serum levels of IL-26 and IL-27 were progressively higher in colorectal cancer group，rectal polyp group and healthy control group（P<0.001）. There was statistical significance in serum IL-26 and IL-27 levels among patients with colorectal cancer with or without lymphatic metastasis，different TNM stages and different degrees of differentiation（P<0.05）. There was no statistical significance for serum IL-26 and IL-27 levels in different ages，sex，presence or absence of distant metastasis，pathological types and tumor sizes of colorectal cancer（P>0.05）. The areas under curves（AUC） of single and combined determinations of IL-26，IL-27，CEA and CA19-9 in diagnosing colorectal cancer were 0.82，0.86，0.81，0.82 and 0.92，respectively. Based on the optimal cut-off values obtained from the ROC curves，the patients with colorectal cancer were classified into high IL-26 level group（41 cases），low IL-26 level group（22 cases） and high IL-27 level group（43 cases），low IL-27 level group（20 cases），respectively. The progression-free survival periods of high IL-26 and high IL-27 level groups were shorter than those of low IL-26 and low IL-27 level groups（P<0.01）. Conclusions Serum levels of IL-26 and IL-27 are abnormally elevated in patients with colorectal cancer and can be used in combination with tumor markers for the auxiliary diagnosis and prognosis assessment of colorectal cancer.

Key words: Interleukin-26, Interleukin-27, Carcinoembryonic antigen, Carbohydrate antigen 19-9, Colorectal cancer, Prognosis

中图分类号:

R446.1

兰俊, 路舒婷, 杨健睿. 结直肠癌患者血清IL-26、IL-27水平检测的临床意义[J]. 检验医学, 2024, 39(1): 7-12.

LAN Jun, LU Shuting, YANG Jianrui. Roles of serum IL-26 and IL-27 levels in patients with colorectal cancer[J]. Laboratory Medicine, 2024, 39(1): 7-12.

图/表 7

参考文献 21

[1]	陈思, 刘华, 刘鷖雯, 等. 血清HER-2、CD44联合检测在结直肠癌中的临床价值[J]. 检验医学, 2022, 37(4):336-341. DOI URL
[2]	BRAY F, FERLAY J, SOERJOMATARAM I, et al. Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6):394-424. DOI URL
[3]	国家消化系统疾病临床医学研究中心上海, 国家消化道早癌防治中心联盟, 中华医学会消化内镜学分会, 等. 中国早期结直肠癌筛查流程专家共识意见(2019,上海)[J]. 中华消化内镜杂志, 2019, 36(10):709-719.
[4]	朱赟洁, 马峥尧, 沈敏娜, 等. 结直肠癌患者血浆cfDNA检测方法的建立及临床应用评估[J]. 检验医学, 2022, 37(6):561-567. DOI URL
[5]	DUAN S, HUANG W, LIU X, et al. IMPDH2 promotes colorectal cancer progression through activation of the PI3K/Akt/ mTOR and PI3K/Akt/FOXO1 signaling pathways[J]. J Exp Clin Cancer Res, 2018, 37(1):304. DOI
[6]	WANG J, NISHIYAMA A, MATSUYAMA M, et al. The(pro) renin receptor:a novel biomarker and potential therapeutic target for various cancers[J]. Cell Commun Signal, 2020, 18(1):39. DOI URL
[7]	XUE T, YANG J, SONG P, et al. Investigation on correlations of serum IL-26 with diagnosis and staging of gastric cancer[J]. JBUON, 2019, 24(1):215-220.
[8]	FABBI M, CARBOTTI G, FERRINI S. Dual roles of IL-27 in cancer biology and immunotherapy[J]. Mediators Inflamm, 2017, 2017:3958069.
[9]	WANG L, CHO K B, LI Y, et al. Long noncoding RNA(lncRNA)-mediated competing endogenous RNA net-works provide novel potential biomarkers and therapeutic targets for colorectal cancer[J]. Int J Mol Sci, 2019, 20(22):5758. DOI URL
[10]	BALACESCU O, SUR D, CAINAP C, et al. The impact of miRNA in colorectal cancer progression and its liver metastases[J]. Int J Mol Sci, 2018, 19(12):3711. DOI URL
[11]	PARSONS M J, KEELY S. FOXO3 loss drives inflammation associated CRC:the consequences of being(knock) out FOX'd[J]. Cell Mol Gastroenterol Hepatol, 2019, 7(2):295-296. DOI URL
[12]	MOHAMMED A, YARLA N S, MADKA V, et al. Clinically relevant anti-inflammatory agents for chemoprevention of colorectal cancer:new perspectives[J]. Int J Mol Sci, 2018, 19(8):2332. DOI URL
[13]	TU H, LAI X, LI J, et al. Interleukin-26 is overexpressed in human sepsis and contributes to inflammation,organ injury,and mortality in murine sepsis[J]. Crit Care, 2019, 23(1):290. DOI
[14]	ITOH T, HATANO R, KOMIYA E, et al. Biological effects of IL-26 on T cell-mediated skin inflammation,including psoriasis[J]. J Invest Dermatol, 2019, 139(4):878-889. DOI URL
[15]	YOU W, TANG Q, ZHANG C, et al. IL-26 promotes the proliferation and survival of human gastric cancer cells by regulating the balance of STAT1 and STAT3 activation[J]. PLoS One, 2013, 8(5):e63588. DOI URL
[16]	LAROCHETTE V, MIOT C, POLI C, et al. IL-26,a cytokine with roles in extracellular DNA-induced inflammation and microbial defense[J]. Front Immunol, 2019, 10:204. DOI URL
[17]	万姗姗, 曹倩. Th17细胞在炎症性肠病发生过程中的效应应答[J]. 世界华人消化杂志, 2013(7):5.
[18]	DANG A T, TELES R M, WEISS D I, et al. IL-26 contributes to host defense against intracellular bacteria[J]. J Clin Invest, 2019, 129(5):1926-1939. DOI PMID
[19]	ZHU X, LIU Z, LIU J Q, et al. Systemic delivery of IL-27 by an adeno-associated viral vector inhibits T cell-mediated colitis and induces multiple inhibitory pathways in T cells[J]. J Leukoc Biol, 2016, 100(2):403-411. DOI URL
[20]	ZHU J, LIU J Q, SHI M, et al. IL-27 gene therapy induces depletion of Tregs and enhances the efficacy of cancer immunotherapy[J]. JCI Insight, 2018, 3(7):e98745. DOI URL
[21]	PARK Y J, RYU H, CHOI G, et al. IL-27 confers a protumor genic activity of regulatory T cells via CD39[J]. Proc Natl Acad Sci U S A, 2019, 116(8):3106-3111. DOI URL

组别	例数	年龄/岁	性别		病变部位		体重指数/（kg·m^-2）	吸烟史/例	饮酒史/例
组别	例数	年龄/岁	男/例	女/例	直肠/例	结肠/例	体重指数/（kg·m^-2）	吸烟史/例	饮酒史/例
结直肠癌组	63	61.4±3.3	40	23	33	30	23.4±2.7	16	11
直肠息肉组	63	60.9±4.9	38	25	36	27	23.1±2.4	12	13
正常对照组	63	61.1±5.4	43	20			23.5±2.6	14	12
统计值		0.187	0.873		0.288		0.413	0.735	0.206
P值		0.829	0.646		0.591		0.662	0.693	0.902

组别	例数	年龄/岁	性别		病变部位		体重指数/（kg·m^-2）	吸烟史/例	饮酒史/例
组别	例数	年龄/岁	男/例	女/例	直肠/例	结肠/例	体重指数/（kg·m^-2）	吸烟史/例	饮酒史/例
结直肠癌组	63	61.4±3.3	40	23	33	30	23.4±2.7	16	11
直肠息肉组	63	60.9±4.9	38	25	36	27	23.1±2.4	12	13
正常对照组	63	61.1±5.4	43	20			23.5±2.6	14	12
统计值		0.187	0.873		0.288		0.413	0.735	0.206
P值		0.829	0.646		0.591		0.662	0.693	0.902

组别	例数	IL-26/（pg·mL^-1）	IL-27/（pg·mL^-1）
结直肠癌组	63	217.53±15.48^*#	142.45±10.42^*#
直肠息肉组	63	184.24±17.86^*	121.71±11.39^*
正常对照组	63	53.22±14.26	48.73±12.09
F值		1 871.594	1 191.229
P值		<0.001	<0.001

组别	例数	IL-26/（pg·mL^-1）	IL-27/（pg·mL^-1）
结直肠癌组	63	217.53±15.48^*#	142.45±10.42^*#
直肠息肉组	63	184.24±17.86^*	121.71±11.39^*
正常对照组	63	53.22±14.26	48.73±12.09
F值		1 871.594	1 191.229
P值		<0.001	<0.001

项目	例数	IL-26/（pg·mL^-1）	IL-27/（pg·mL^-1）
年龄
≥60岁	38	218.58±14.47	143.75±8.67
<60岁	25	216.05±13.79	141.98±9.22
t值		0.702	0.773
P值		0.486	0.442
性别
男	40	218.42±14.97	143.01±9.02
女	23	216.33±13.24	141.78±9.24
t值		0.556	0.517
P值		0.580	0.607
淋巴转移
有	29	231.08±4.42	149.66±2.71
无	34	205.97±3.46	136.34±3.39
t值		25.278	17.018
P值		<0.001	<0.001
病理类型
溃疡型	48	217.08±15.47	142.34±10.21
隆起型	11	216.94±14.72	142.51±10.09
浸润型	4	218.05±13.02	142.23±10.35
F值		0.009	0.002
P值		0.991	0.998
远隔转移
有	12	219.31±12.49	142.67±9.86
无	51	216.84±14.50	142.13±9.45
t值		3.667	0.177
P值		0.004	0.861
TNM分期
Ⅰ~Ⅱ	30	204.94±2.27	129.74±4.73
Ⅲ~Ⅳ	33	228.97±5.41	151.01±2.46
t值		23.355	22.066
P值		<0.001	<0.001
肿瘤大小
≥5 cm	29	218.92±13.09	142.72±9.32
<5 cm	34	216.78±14.41	142.10±9.26
t值		0.613	0.264
P值		0.542	0.793
分化程度
低	15	227.94±6.02	149.69±2.28
中	36	216.49±13.36^*	139.71±2.04^*
高	12	207.63±4.13^*#	133.47±1.87^*#
F值		12.275	64.354
P值		<0.001	<0.001