Comparative Estimation of Serum Osteopontin, Tumor Necrosis Factor-a and IL-6 As An Indicator for Immune Dysregulation in Nasopharyngeal Carcinoma
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- Category: Vol. 77, June 2009
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Comparative Estimation of Serum Osteopontin, Tumor Necrosis Factor-a and IL-6 As An Indicator for Immune Dysregulation in Nasopharyngeal Carcinoma,AHMAD AL-HADY, MOSTAFA HASSAAN, ISMAIL AL-NASHAR, KHALED AL-MESALLAMY, ABD EL-RAOF SAID, MAHER EIDAROS, ATEF GODA and SHERIN AL-TARHONY
Abstract
Objectives: The present study was designed to evaluate serum levels of osteopontin (OPN), tumor necrosis factor-a (TNF-a) and interleukin-(IL)-6 in pre-treatment samples obtained from patients with biopsy confirmed nasopharyngeal carcinoma (NPC).
Patients and Methods: The study included 28 NPC pa-tients; 20 males and 8 females with mean age of 56.8±8 years. Cervical lymphadenopathy was the main presenting symptom in 19 patients (67.9%), recurrent unexplained attacks of epistaxis in 16 patients (57.1%) and 7 patients (25%) had secretory otitis media. Patients were clinically categorized using TNM staging and underwent nasopharyngoscopy and biopsy taking for pathological examination and grading according to the World Health Organization (WHO) types. All patients received chemotherapy and or radiotherapy and completed their follow-up at ENT outpatient clinic. Pre- and post-treatment blood samples were collected for estimation of serum level of osteopontin (OPN), tumor necrosis factor-a (TNF-a) and interleukin-(IL)-6. Blood samples were ob-tained from 10 healthy volunteers as control group.
Results: Pre-treatment serum levels of estimated param-eters were significantly higher compared both to control levels and to post-treatment levels. However, despite treatment induced significant decrease of serum levels of estimated parameters, their levels still significantly higher compared to control levels. There was a positive significant correlation between TNM clinical staging and serum levels of OPN, TNF-a and IL-6. Also, WHO pathological types showed a positive significant correlation with serum levels of OPN and IL-6, but the correlation with TNF-a was positive non-significant. Using ROC analysis for estimated parameters as screening test for WHO type 1 lesions defined estimation of serum OPN as a good screening test to detect early lesions and defined 2 cutoff points for serum OPN; namely: 265 and 298 ng/ml, had identical screening power; however, cutoff point at 265 ng/ml showed significantly higher of sensitivity rate (89.3%).
Conclusion: NPC is associated with immune dysregulation in favor of Th1 side and elevated OPN pre-treatment serum levels that could be used as screening test for early cases of NPC and as a preliminary screening test with cutoff point at 265 ng/ml as discriminative value.