肝内胆管癌患者血清CXCL9和IFN-γ水平变化及其临床意义探讨

doi:10.3969/j.issn.1672-5069.2021.05.034

摘要/Abstract

摘要： 目的探讨肝内胆管癌(ICC)患者血清C-X-C趋化因子配体9(CXCL9)和干扰素-γ(IFN-γ)水平变化及其临床意义。方法 2012年1月～2017年1月我院诊治的63例ICC患者和同期63例健康体检者,所有患者接受根治性肿瘤切除术,随访36个月。采用ELISA法检测血清CXCL9和IFN-γ水平,用Kaplan-Meier生存曲线分析不同血清CXCL9和IFN-γ水平的ICC患者预后的差异。结果 ICC患者血清CXCL9水平为(820.7±185.6)pg/mL,显著高于健康人【(275.1±51.3)pg/mL,P<0.05】,血清IFN-γ水平为(18.7±7.2)ng/L,显著低于健康人【(59.3±18.3)ng/L,P<0.05】;不同TNM分期(Ⅰ/Ⅱ期对Ⅲ/Ⅳ期)、有无淋巴结转移和低分化与中/高分化的ICC患者血清CXCL9和IFN-γ水平差异显著(P<0.05);对63例ICC患者随访36个月,结果死亡42例(66.7%),生存21例(33.3%);以ICC患者血清CXCL9水平为820.7 pg/mL为截断点,低水平者30例,高水平者33例,经Kaplan-Meier生存分析显示,血清CXCL9低水平的ICC患者术后36个月生存率为53.3%,显著高于CXCL9高水平组的15.2%(x²=12.448,P<0.001);以ICC患者血清IFN-γ水平为18.7 ng/L为截断点,低水平者34例,高水平者29例,IFN-γ低水平组术后36个月生存率为14.7%,显著低于高水平组的55.2%(x²=10.554,P=0.001)。结论 ICC患者血清CXCL9水平升高,而血清IFN-γ水平降低。它们均与ICC患者根治性手术后的预后相关,检测血清CXCL9和IFN-γ水平有助于评估ICC患者的预后,值得进一步研究。

关键词: 肝内胆管癌, C-X-C趋化因子配体9, 干扰素-γ, 预后

Abstract: Objective The purpose of this study was to investigate the clinical implication of serum C-X-C chemokine ligand 9 (CXCL9) and interferon-γ (IFN-γ) levels in patients with intrahepatic cholangiocarcinoma (ICC). Methods A total of 63 patients with ICC and 63 healthy persons were enrolled in our hospital between January 2012 and January 2017, and all patients underwent radical tumor removal and followed-up for 36 months. Serum levels of CXCL9 and IFN-γ were detected by enzyme-linked immunosorbent assay. The Kaplan-Meier survival curve was applied to analyze serum CXCL9 and IFN-γ levels in predicting the prognosis of patients with ICC after operation. Results Serum CXCL9 and IFN-γ levels in patients with ICC were (820.7±185.6)pg/mL and (18.7±7.2)ng/L, significantly different as compared to or in healthy persons; there were significant differences as respect to serum CXCL9 and IFN-γ levels between ICC patients with TNM stage Ⅰ/Ⅱ vs. stage Ⅲ/Ⅳ, with or without lymph node metastasis, and poorly vs. moderately/highly differentiated tumors(P<0.05); at the end of 36 month follow-up, 42 (66.7%) patients with ICC died and 21 (33.3%)patients survived in our series; 30 patients with ICC had low and 33 had high serum CXCL9 levels when 820.7 pg/mL was set as the cut-off-value, and the Kaplan-Meier analysis showed that the 36_mon survival in patients with low serum CXCL9 levels was 53.3%, significantly higher than 15.2%(x²=12.448, P<0.001)in patients with high serumCXCL9 levels; 34 ICC patients had low and 29 patients had high serum IFN-γ levels when 18.7 ng/L was set as the cut-off-value, and the 36_mon survival in patients with low serum IFN-γ levels was 14.7%, significantly lower than 55.2%(x²=10.554,P=0.001) in patients with high serum IFN-γ levels. Conclusion Serum CXCL9 levels increase and serum IFN-γ levels decrease in patients with ICC, and serum CXCL9 and IFN-γ levels are correlated with the prognosis of ICC patients after radical operation. The surveillance of serum CXCL9 and IFN-γ levels in this setting is helpful to evaluate the prognosis of patients with ICC.

Key words: Intrahepatic cholangiocarcinoma, C-X-C motif chemokine ligand 9, Interferon-γ, Prognosis

宋雪, 席子涵, 李婷, 周苗. 肝内胆管癌患者血清CXCL9和IFN-γ水平变化及其临床意义探讨[J]. 实用肝脏病杂志, 2021, 24(5): 741-744.

Song Xue, Xi Zihan, Li Ting, et al. Clinical implication of serum CXCL9 and IFN-γ levels in patients with intrahepatic cholangiocarcinoma[J]. Journal of Practical Hepatology, 2021, 24(5): 741-744.

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