Pretreatment serum interleukin-1, interleukin-6, and tumor necrosis factor- levels predict the progression of colorectal cancer

The correlations of pretreatment serum concentrations of proinflammatory cytokines such as interleukin (IL)-1, IL-6, and tumor necrosis factor- (TNF) with the clinicopathologic features and progression of colorectal cancer (CRC) were investigated. The pretreatment serum levels of IL-1, IL-6, and TNF were measured in 164 CRC patients before treatment. The relationships between changes in proinflammatory cytokine and C-reactive protein (CRP) levels and both clinicopathologic variables and disease progression were examined by univariate and multivariate analysis. Advanced tumor stage was associated with a poorer histologic differentiation, higher CRP level, lower albumin level, and inferior progression-free survival rate (PFSR). Furthermore, high levels of CRP (>5mg/L) were associated with proinflammatory cytokine intensity, defined according to the number of proinflammatory cytokines with levels above the median level (IL-110pg/mL; IL-610pg/mL; and TNF55pg/mL). Under different inflammation states, proinflammatory cytokine intensity, in addition to tumor stage, independently predicted PFSR in patients with CRP <5mg/L, whereas tumor stage was the only independent predictor of PFSR in patients with CRP 5mg/L. Proinflammatory cytokine intensity and the CRP level are clinically relevant for CRC progression. Measurement of IL-1, IL-6, and TNF serum levels may help identify early cancer progression among patients with CRP <5mg/L in routine practice.