Kolorektalni karcinom: procena sistemskih vrednosti interleukina-1 i interleukina-33 kod bolesnika sa i bez trombocitoze

Miodrag  Jocić; Nevena Gajović; Milena  Jurišević; Marina Jovanović; Nataša Zdravković; Nebojša  Arsenijević; Vesna Vuković Dejanović; Veljko Marić; Boško  Milev; Milan Jovanović

doi:10.2298/VSP190910110J

Miodrag Jocić 1Institute for transfusiology and haemobiology, Military Medical Academy, Belgrade, Serbia
Nevena Gajović University of Kragujevac, Faculty of Medical Sciences, Center for Molecular Medicine and Stem Cell Research, Kragujevac, Serbia
Milena Jurišević University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
Marina Jovanović University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
Nataša Zdravković University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
Nebojša Arsenijević University of Kragujevac, Faculty of Medical Sciences, Center for Molecular Medicine and Stem Cell Research, Kragujevac, Serbia
Vesna Vuković Dejanović Institute for Rehabilitation, Department of Cardiology Rehabilitation, Belgrade, Serbia
Veljko Marić University of East Sarajevo, Faculty of Medicine, Department of Surgery, Foča, Bosnia and Herzegovina
Boško Milev Military Medical Academy, Clinic of General and Abdominal Surgery, Belgrade, Serbia
Milan Jovanović Military Medical Academy, Emergincy Department, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP190910110J

Keywords: kolorektalne neoplazme;, trombocitoza;, citokini;, interleukini.

Abstract

Uvod/Cilj. Reaktivna trombocitoza, kao paraneoplastični sindrom, često se sreće kod obolelih od karcinoma. Različiti humoralni faktori i citokini povezani sa tumorom doprinose povećanom stvaranju trombocita. Međutim, tačna uloga ovih citokina u patogenezi trombocitoze nije potpuno jasna. Cilј studije je bio da se analiziraju sistemske vrednosti citokina i kliničko-patološke karakteristike kod obolelih od kolorektalnog karcinoma (CRC) sa i bez trombocitoze. Metode. U istraživanje je bilo uklјučeno 59 bolesnika sa CRC, podelјenih u dve grupe u zavisnosti od broja trombocita. Analizirani su podaci o: starosti, polu, veličini tumora, lokalizaciji, metastazama, invaziji krvnih ili limfnih sudova, nuklearnom

gradusu, stepenu histološke diferencijacije, tumor, nodus, metastaza (TNM) stadijumu i serumskim koncentracijama citokina [interleukina (IL)-1, IL-33, IL-12, IL-17 i interferona (IFN)-γ] kod obe grupe ispitanika. Rezultati. Oboleli od CRC sa trombocitozom imali su značajno veći nuklearni gradus karcinoma (p = 0,002); veći procenat detektabilnih metastatskih lezija u jetri (p = 0,002), plućima (p = 0,001), karcinomatoza peritoneuma (p = 0,001), detektibilnih invazija krvnih (p = 0,012) i limfnih sudova (p = 0,010). Takođe, kod obolelih od CRC sa trombocitozom zabeležene su veće koncentracije tumorskih markera [alfafetoproteina (AFP), karcinoembrionalnog antigena (CEA) i karcinomskog antigena 19-9 (CA 19-9)] i serumskih vrednosti IL-1 i IL-33. IL-1/IL-12 (p = 0,016), IL-1/IFN-γ (p = 0,007), IL-1/IL-17 (p = 0,006), IL-33/IL-12 (p = 0,001), IL-33/IFN-γ (p = 0,001), IL-33/IL-17 (p = 0,002), and IL-33/IL-1 (p = 0,006) odnosi bili su značajno veći kod obolelih od CRC sa trombocitozom u odnosu na obolele od CRC bez trombocitoze. Analiza Receiver Operating Characteristic (ROC) krivulje pokazuje da se IL-1 (AUC = 0,718; 95% Cl: 0,567–0,868); osetlјivost 69,2%, specifičnost 62,9% i IL-33 (AUC = 0,763; 95% Cl: 0,614–0,911); osetlјivost 84,6%, specifičnost 65,7%, mogu koristiti kao potencijalni markeri paraneoplastične trombocitoze kod obolelih od CRC. Zaključak. IL-1 i IL-33 značajno koreliraju sa brojem trombocita kod bolesnika sa agresivnijom formom kolorektalnog karcinoma.

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