The Evaluation Of Interleukin-6 As A Tumor Sign In The Diagnosis And Prognosis Of Ovary Cancer

Objectives: The death rate of ovary cancer ranks first, with its frequency of occurrence second to cervical cancer and carcinoma of endometrium among the female reproductive organ malignant tumors. Infiltration followed by proliferation is found in the cases of cervical cancer and endometrium. But early proliferation appears in ovary cancer patients' pelvic and abdominal cavity and lymphatic metastasis happens, which characterizes the clinical features of ovary cancer as late diagnosis and early proliferation. 80%-90% of ovary cancer patients can survive in the first 5 years with effective treatment in early stage. But due to the incapability of early diagnosis, only 20%-30% of advanced stage patients can survive in the first 5 years. Hence early diagnosis is essential if the survival period of ovary cancer patients is to be prolonged. One of the important testing indexes of early diagnosis is the level of the interleukin-6 (IL-6) in blood serum. IL-6 is a cytokine with multiple biological activities,which include the induction and regulation of immune response and inflammatory reactions. It stimulates the growth of tumor and makes the reproduction of cells out of control, leading to cancer metastasis and deterioration. The research aims to explore the significance of using IL-6 as a new tumor sign to diagnose early stage of ovary cancer and to distinguish malignant ovary tumor from non-malignant ones by testing the IL-6 level in the serum of ovary cancer patients, ovary non-malignant tumor patients and healthy women. Meanwhile, the significance of IL-6 in monitoring the effectiveness of treatment is also expected to be established through dynamic observation of the changes of IL-6 level before and after the treatment.Materials and Methods: Altogether, 27 untreated patients of epithelial ovarian cancer were chosen between January, 2003 and December, 2004, among whom 17 cases were serous cystadeno carcinoma, 7 cases mucinous carcinoma and 3 cases endometrioic carcinoma. All the cases were pathologically confirmed after operations. 10 cases were chosen for dynamic monitoring. And non-malignant ovary tumor group, healthy group, endometriosis group and group of other gynecopathical malignant tumor were formed as control groups. The IL-6 level in serum were tested with Enzyme-linked Immunoabsorbent Assay (ELISA).Results: 1) The average IL-6 level of the epithelial ovarian cancer group was 175.336±73.771 pg/ml, significantly higher than that of the healthy group (14.884±9.480 pg/ml).The difference was of statistical significance (P<0.05). The average IL-6 level of the non-malignant ovary tumor group was 16.038 ±9.755 pg/ml, not significantly different from that of the healthy group( P>0.05), but statistically different from that of the epithelial ovarian cancer group(P<0.05). The average IL-6 level of the 8 cases of endometriosis was 16.826±2.45pg/ml, and the IL-6 level of the group of other gynecopathical malignant tumor was 6.787±6.105 pg/ml, both of which were not significantly different from the healthy group ( P>0.05) but significantly different from the epithelial ovarian cancer group(P<0.05). 2) In the epithelial ovarian cancer group, the average level of IL-6 of 9 cases of the III stage patients was 163.765± 54.588 pg/ml, and that of the 18 cases of I-II stage patients was 101.069±42.080 pg/ml. The difference between them was significant(P<0.05). It was indicated that the density of IL-6 in the serum of epithelial ovarian cancer patients varied with stages and increased as stages advanced. 3) By tracking the IL-6 level of 10 epithelial ovarian cancer patients, the IL-6 level was found to be obviously higher than normal before the operation. But swift decrease happened after operation and chemiotherapy without process ofgradual decrease.Conclusions: 1) The IL-6 level of the epithelial ovarian cancer patients is obviously higher than those of the other groups. Meanwhile, it increases as the stages advances, which indicates that IL-6 is of characeristic in the diagnosis, especially the early diagnosis of ovary cancer. 2) IL-6 is not sensible to the other gynecopathical malignant tumors, which reveals its importance in distinguishing malignant ovary cancers from non-malignant ones and further confirms the characeristic of IL-6 in the diagnosis of epithelial ovarian cancers. 3) No increase of IL-6 level is found in the cases of endometriosis. 4) Although IL-6 can be used as an indicative index of epithelial ovarian cancers, the swift decrease after operation and chemiotherapy makes it inadequate to be used as a sign to judge whether chemiotherapy and medicine treatment should be stopped or whether a relapse has happened.