RESUMEN
BACKGROUND: To evaluate the predictive and prognostic value of serum and plasma tumor markers, in comparison with clinical and biomedical parameters for response rate (RR), progression-free survival (PFS) and overall survival (OS) among patients with metastatic colorectal cancer (mCRC) treated with combination chemotherapy. MATERIAL AND METHODS: One-hundred and six patients with mCRC from three centers, part of a multicenter study, received irinotecan with the Nordic bolus 5-fluorouracil (5-FU) and folinic acid schedule (FLIRI) or the de Gramont schedule (Lv5FU2-IRI). Blood samples for CEA, CA19-9, TPA, TIMP-1, SAA, transthyretin and CRP were taken at baseline and after two, four and eight weeks of treatment. Tumor marker levels at baseline and longitudinally were compared with responses evaluated (CT/MRI) after two and four months of treatment. The correlations to RR, PFS and OS were evaluated with regression analyses. RESULTS: A significant correlation to OS was seen for baseline levels of all markers. In multivariate analyses with clinical parameters, TPA, CRP, SAA and TIMP-1 provided independent information. The baseline values of CEA, TPA and TIMP-1 were also significantly correlated to PFS and TPA to RR. Changes during treatment, i.e. the slope gave with the exception of CA19-9 for OS less information about outcomes. The best correlation to response was seen for CEA, CA19-9 and TPA with AUC values of 0.78, 0.83 and 0.79, respectively, using a combined model based upon an interaction between the slope and the baseline value. CONCLUSIONS: Baseline tumor markers together with clinical parameters provide prognostic information about survival in patients with mCRC. The ability of the individual tumor markers to predict treatment response and PFS is limited. Changes in marker levels during the first two months of treatment are less informative of outcome.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biomarcadores de Tumor/sangre , Neoplasias Colorrectales/sangre , Neoplasias Colorrectales/tratamiento farmacológico , Adulto , Anciano , Área Bajo la Curva , Proteína C-Reactiva/metabolismo , Antígeno CA-19-9/sangre , Camptotecina/administración & dosificación , Camptotecina/análogos & derivados , Antígeno Carcinoembrionario/sangre , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/patología , Supervivencia sin Enfermedad , Esquema de Medicación , Estudios de Evaluación como Asunto , Femenino , Fluorouracilo/administración & dosificación , Humanos , Irinotecán , Leucovorina/administración & dosificación , Modelos Lineales , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estadificación de Neoplasias , Prealbúmina/metabolismo , Valor Predictivo de las Pruebas , Pronóstico , Receptores de Albúmina/sangre , Sensibilidad y Especificidad , Proteína Amiloide A Sérica/metabolismo , Suecia , Inhibidor Tisular de Metaloproteinasa-1/sangre , Antígeno Polipéptido de Tejido/sangreAsunto(s)
Antígenos de Superficie de la Hepatitis B/sangre , Hepatitis B/diagnóstico , Precursores de Proteínas/sangre , Animales , Biomarcadores/sangre , Antígenos de Superficie de la Hepatitis B/fisiología , Vacunas contra Hepatitis B , Virus de la Hepatitis B/genética , Humanos , Precursores de Proteínas/fisiología , Receptores de Albúmina/sangre , Proteínas del Envoltorio Viral/fisiología , Ensamble de VirusRESUMEN
BACKGROUND: To investigate the relationship between interleukin-6 (IL-6) levels in serum and HBV replication and the role of IL-6 in liver damage in chronic hepatitis B patients. METHODS: Detected IL-6 levels and polymerized human serum albumin receptor (PHSA-R) in serum of different type of HBV markers positive patients and of different degree of chronic hepatitis B patients. RESULTS: The results showed that the serum IL-6 levels were increased significantly in PHSA-R positive patients than in PHSA-R negative patients in chronic hepatitis B (P<0.01). The serum IL-6 levels were correlated with the levels of PHSA-R (r=0.694, P<0.01), and the degree of symptoms. CONCLUSIONS: This study suggested that the IL-6 levels in serum of hepatitis B patients correlated HBV replication and the degree of liver damage, serum IL-6 levels may be used as a value indicating of HBV replication, the degree of symptoms and the effect of treatment.