ABSTRACT
Background:Chronic inflammation is closely associated with occurrence and development of gastric cancer,and inflammatory cytokines,interleukin-18(IL-18)and IL-1β are involved via a variety of mechanisms. Aims:To determine the serum levels of IL-18 and IL-1β in patients with different gastric mucosal lesions and to explore the role of these two cytokines in gastric cancer and their clinical significance. Methods:Serum levels of IL-18 and IL-1β were detected by ELISA in patients with different gastric mucosal lesions,including 324 gastric cancer,40 chronic non-atrophic gastritis (CNAG),13 chronic atrophic gastritis with or without intestinal metaplasia(CAG/ IM)and 20 mild to moderate dysplasia. Helicobacter pylori(Hp)IgG antibody was detected in patients with gastric cancer. Correlations of serum levels of IL-18 and IL-1β with clinicopathological parameters and Hp infection were analyzed in patients with gastric cancer. RoC curve was used to assess the performance of serum IL-18 and IL-1β for diagnosis of gastric cancer. Results:Serum levels of IL-18 and IL-1β increased gradually from CNAG,CAG/ IM,dysplasia to gastric cancer;except for IL-1β between CNAG and CAG/ IM groups,significant differences were found between any two groups(P < 0. 05). In gastric cancer group,they were positively correlated with tumor size,lymph node and distant metastases,depth of invasion,TNM stage and Hp infection(P < 0. 05). Area under the RoC curve(AUC)of combined detection of serum IL-18 and IL-1β for diagnosis of gastric cancer was superior to that of IL-18 or IL-1β detection alone(0. 867 vs. 0. 837 and 0. 795). Conclusions:Serum levels of IL-18 and IL-1β increase dynamically with the tumorigenesis of gastric cancer,and are closely related to growth, invasiveness and metastasis of gastric cancer. Combined detection of serum IL-18 and IL-1β might be used as a biomarker for diagnosis and tumor progression and prognosis assessment of gastric cancer.
ABSTRACT
Background:Matrix metalloproteinase-9(MMP-9)is known to play a key role in tumor invasion and metastasis by mediating the degradation of extracellular matrix. It has been revealed that neutrophil gelatinase-associated lipocalin ( NGAL)is capable of protecting MMP-9 from degradation and thereby preserving its enzymatic activity. Aims:To explore the MMP-9 and NGAL levels in peripheral blood of gastric cancer patients and their clinical significance. Methods:Serum levels of MMP-9 and NGAL were determined by ELISA in 76 gastric cancer patients and 50 healthy controls. Correlations of serum MMP-9 and NGAL levels with clinicopathological features of gastric cancer were analyzed,and their diagnostic performance for screening gastric cancer was evaluated by ROC curve. Results:Serum levels of MMP-9 and NGAL in patients with gastric cancer were significantly higher than those in healthy controls(P<0. 01),and either of them was positively correlated with the TNM stage of gastric cancer. Furthermore,MMP-9 was correlated with lymph node metastasis and serosal invasion,while NGAL was correlated with distant metastasis. However,tumor differentiation was not correlated with either MMP-9 or NGAL. By ROC curve,608. 19 ng/mL and 14. 71 ng/mL were identified as the cutoff value of serum MMP-9 and NGAL,respectively,for screening gastric cancer. Sensitivity and specificity of MMP-9 were 64. 5% and 90. 0%,and those of NGAL were 85. 5% and 90. 0%,respectively. When parallel test was taken,the sensitivity would be increased to 94. 7% and specificity being 82. 0%. Conclusions:Serum levels of MMP-9 and NGAL are elevated and associated with tumor progression in patients with gastric cancer. Both of them might be used as potential markers for screening,disease assessment and prognosis prediction of gastric cancer.