Relationship Between Glioma Patient’s Serum Level Of IL- 4 And Its Prognosis

Purpose: Glioma originates from neural epithelium. It is one of the most common and most difficult malignant tumors to manage. The incidence of glioma is about 40-50% of all intracranial tumors. In recent years, although after the tireless efforts of medical workers, the survival rate and survival period of patients with glioma has not shown obvious improvement. Grading and classification of glioma can provide an important basis for the judgment of surgery and postoperative comprehensive therapy which is of great significance for the selection of proper treatment and to improve prognosis. Interleukin 4(IL- 4) is produce by CD4 + T cells which stimulated by the antigen or mitosis. Activation of mast cells can also produce IL- 4. In recent years, the research for relationship between cytokines and tumor development has attracted the attention of numerous brain scientists and clinicians, the study found that IL- 4 closely associated with the occurrence of tumor, and diagnosis and prognosis is associated with it. Ki- 67 is a kind of proliferating cell nuclear antigen, mainly distributed in nuclei, now it known to have close relation with cellular mitosis. As clear known markers for cell proliferation, Ki- 67 has been widely applied in the assessment of tumor proliferation activity, and also known as a very important factor affecting the prognosis of tumor(including glioma). In this study, preoperative serum level of IL- 4 were measured by ELISA for 8 cases of normal volunteers and 21 patients with glioma, and then compared with pathology classification of glioma and expression of Ki- 67 tested by immunohistochemical. Tried to find a new simple way for evaluation of glioma grading before surgery, to help determine the treatment plan.Methods:This study randomly select 21 cases of surgically treated primary glioma performed at the Department of Neurosurgery, 2nd Hospital of Hebei Medical University from June to December 2014. According to the WHO 2007 grading, 9 cases are in low level group(WHO grade Ⅰ- Ⅱ), and 12 cases are in high level group(WHO grade Ⅲ- Ⅳ). After medical examination 8 healthy adults were selected as normal control group. Blood sample of the experimental group were collected 1 day prior to surgery after informing the patient’s family about the test. The blood sample of the normal control group was also taken after informing the family about the test to be done. Glioma specimens was taken from the edge of intraoperative tumor and normal brain tissue at the junction of partial tumor side about 1×1×1 cm size samples.The concentration of IL-4 is tested by ELISA after the blood samples made into serum. Ki- 67 scores tested by immunohistochemical method to detect tumor specimens. The experimental data was analyzed by SPSS 19.0 software, data recorded deviated in mean ± standard deviation. IL- 4 levels in serum and the level of glioma divided by single factor analysis of variance, and compared with the expression of Ki- 67 coefficient using Kolmogorov Smirnov inspection.Results: 1 General condition of patients and pathological types: This study includes 21 cases with primary brain glioma patients. The patients were 12 males, 9 female ranging in age from 17 to 64 years old(mean 40.4 ±14.4 years old). As classified according to the WHO 2007 standard, there are 2 cases of grade Ⅰ astrocytoma, 5 cases of grade Ⅱ oligodendroglioma, 2 cases of grade Ⅱ ependymoma, 4 cases of grade Ⅲ anaplastic astrocytoma, 3 cases of grade Ⅲ anaplastic oligodendroglioma, 1 cases of grade Ⅲ ependymoma and 4 cases of grade Ⅳ pleomorphic glioblastoma cell tumor. WHO grade Ⅰ and Ⅱ is of low grade group and there are 9 cases, 6 males and 3 females ranging in the age from 19 to 48 years old(33.7 ±10.7 years old). WHO Ⅲ and Ⅳ grade is of high grade groupand there are 12 cases, 5 males, 7 females ranging in age from 17 to 64 years old(45.5 ±15.1 years old). This study also include normal control group of 8 healthy adult cases, 3 males, 5 females, ranging in age from 23 to 57 years old(40.1 ± 11.7 years old). Among the three groups, differences between groups is F=2.14,and P of difference were greater than 0.05, no significant difference between the three groups. 2 The comparison between IL- 4 concentrations in serum and the level of glioma Serum ELISA test was done to measure IL-4 level in serum in cases of control group of 8 healthy adults and 21 patients with brain glioma(low grade group 9 cases, high grade group 12 cases). The test results for the 8 cases: the mean value of the content of IL-4 in the serum of healthy adult was 14.48 ± 1.5pg/ml, 9 cases of low grade glioma group was 20.16 ± 1.83 pg / ml, 12 cases of high grade glioma group was 37.2 ± 5.73 pg / ml. Comparison between the values with the normal control group, low grade gliomas and high-grade gliomas patients for serum IL-4 levels were significant(P<0.05); high level of serum IL-4 was observed in low grade group(P<0.05). 3 The comparison between different Li- 67 expression in scores in different glioma group of the level Immunohistochemical detection was done in 21 cases with brain gliomas(9 cases of low grade, 12 cases of high grade glioma) for Ki-67 expression in glioma tissue fraction. The test results show that: Ki-67 in the group of low grade glioma tissues per 100 cells was 6.8 ± 4.9; high grade group tumor tissues in every hundred cells were 35.4 ± 15.1. The positive expression of Ki-67 was higher in high grade group tumor tissue than that of low-level group, there was significant difference between two groups(P<0.05). 4 The comparison between serum concentrations of IL- 4 with glioma tissues expression of Ki- 67 scores Using the single sample Kolmogorov Smirnov inspection to test the relationship between serum concentrations of IL- 4 with glioma tissues expression of Ki- 67 scores. Two data are accord with normal distribution, R= 0.653, P = 0.001 < 0.01, has significant correlation, and calculate the regression equation: Y = 2.0156 + 0.9714 X, determination coefficient R2 = 0.4511.Conclusions: The serum concentration of IL- 4 between glioma patients and healthy adults is different, and there is a difference of serum concentration of IL – 4 between high level and low level group patients, which are statistically significant. This means that IL- 4 concentrations in serum can be used as a prognostic factor.