期刊
BRITISH JOURNAL OF CANCER
卷 113, 期 11, 页码 1581-1589出版社
SPRINGERNATURE
DOI: 10.1038/bjc.2015.379
关键词
clear-cell renal cell carcinoma; interleukin-6; interleukin-6 receptor; prognostic biomarker; conditional survival; cancer-specific survival; organ-confined disease
类别
资金
- National Basic Research Program of China [2012CB822104]
- National Natural Science Foundation of China [31100629, 31270863, 81471621, 81472227]
- Program for New Century Excellent Talents in University [NCET-13-0146]
- Shanghai Rising-Star Program [13QA1400300]
Background: Interleukin-6 (IL-6) is the major cytokine that induces transcriptional acute and chronic inflammation responses, and was recently incorporated as a recurrence prognostication signature for localised clear-cell renal cell carcinoma (ccRCC). As the prognostic efficacy of initial risk factors may ebb during long-term practice, we aim to report conditional cancer-specific survival (CCSS) of RCC patients and evaluate the impact of IL-6 as well as its receptor (IL-6R) to offer more relevant prognostic information accounting for elapsing time. Methods: We enrolled 180 histologically proven localised ccRCC patients who underwent nephrectomy between 2001 and 2004 with available pathologic information. Five-year CCSS was determined and stratified by future prognostic factors. Constant Cox regression analysis and Harrell's concordance index were used to indicate the predictive accuracy of established models. Results: The 5-year CCSS of organ-confined ccRCC patients with both IL-6- and IL-6R-positive expression was 52% at year 2 after surgery, which was close to locally advanced patients (48%, P = 0.564) and was significantly poorer than organ-confined patients with IL-6-or IL-6R-negative expression (89%, P<0.001). Multivariate analyses proved IL-6 and IL-6R as independent predictors after adjusting for demographic factors. Concordance index of pT-IL-6-IL-6R risk stratification was markedly higher compared with the stage, size, grade and necrosis prognostic model (0.724 vs 0.669, P = 0.002) or UCLA Integrated Staging System (0.724 vs 0.642, P = 0.007) in organ-confined ccRCC population during the first 5 years. Conclusions: Combined IL-6 and IL-6R coexpression emerges as an independent early-stage immunologic prognostic factor for organ-confined ccRCC patients.
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