Prognostic Role Of Serum Cytokines In Patients With Nasopharyngeal Carcinoma

Objective:We aimed to evaluate the relationship between serum cytokines and clinical outcome in patients with nasopharyngeal carcinoma （NPC）.Methods:The concentrations of IL-2, TNF-α, IFN-γ, IL-4, IL-5, and IL-10in serum were examined by Cytometric Bead Array in a total of80nasopharyngeal carcinoma patients pre-and post-treatment. Associations of those cytokines with clinical pathological factors, treatment response and overall survival were analyzed.Results:NPC stage was positively correlated with pretreatment serum level of IFN-y （r=0.22,p=0.05）, TNF-a（r=0.26, p=0.02）. Patients with non-keratinizing carcinoma had significantly higher IFN-y expression than patients with keratinizing carcinoma （18.19vs.10.11, P=0.012）. The concentration of IL-10and IL-5was significantly increased after treatment, compared with that before treatment （4.25vs.3.50,P=0.000;3.02vs.2.58, P=0.020）. Patients with low expression of IL-5were less likely to be partial-responders compared to those with high expression, the OR was0.19（95%CI: 0.05₀.78, p=0.021） after adjusting for patient gender, age at diagnosis, disease stage and histological type. However no association of IL5with overall survival was found. Serum level of TNF-a and IL-2pretreatment were closely associated with overall survival. Compared to patients with low TNF-a expression, those with high expression had a more than two-fold increase in risk of death（HR=2.66,95%CI:1.04-6.78, p=0.041）. While IL-2showed opposite effect on overall survival in patients with NPC. Patients with high IL-2expression had less risk of death than those with low IL-2（HR=0.31,95%CI:0.13-0.75, p=0.009）. All HRs were adjusted for age, gender, stage, histology, and treatment. Kaplan-Meier survival analysis showed similar survival differences between the two groups.Conclusions:An elevated serum TNF-a or declined serum IL-2concentration predicts an unfavorable prognosis for patients with NPC.