Relação de citocinas séricas com fatores prognósticos e neoplasias malignas de ovário.

Abstract

INTRODUCTION: Ovarian cancer is a disease of multifactorial origin with difficult early diagnosis. It has an insidious evolution, with late symptomatology, which leads to delayed diagnosis and treatment, reducing therapeutic possibilities. There are differences in the tumor micro-environment between benign, malignant and non-neoplastic tumors, suggesting a role of cytokines in tumor progression. There are no studies on the local and systemic production of cytokines in relation to the various prognostic factors in the same group of patients. OBJECTIVES: The aims were to relate cytokines serum levels (TH1 standard: IL-2, IL-8, and TNF-α, TH2 standard: IL-5, IL-6 and IL-10) with clinical, laboratory and pathological prognostic factors in patients with primary malignant ovarian neoplasia. MATERIALS AND METHODS: Patients (n=30) of the Pelvic Mass Ambulatory of the Discipline of Gynecology and Obstetrics / Oncology Research Institute (IPON) of the Federal University of the Triângulo Mineiro - UFTM with surgical indication according to pre- established criteria were evaluated. There will be collection of preoperative serum for the dosage of tumor markers. Patients with a confirmed diagnosis of malignant epithelial ovarian neoplasia (n = 30) were included. Exclusion criteria were torsion of the adnexal pedicle, secondary malignant ovarian neoplasia (metastasis), previous antineoplastic treatment; malignant germ cell malignancies or sexual ovarian cords neoplasms; immunosuppressive diseases; and relapse. ELISA for TH1 standard cytokines: IL-2, IL-8, and TNF-α, and TH2 standard: IL-5, IL-6 and IL-10 was performed. The age, type and histological grade, staging, lymph node metastasis, classification in type I and II of ovarian cancer, disease-free survival, overall survival, tumor markers, neutrophil-lymphocyte ratio (RNL), platelet-lymphocyte ratio (PLR), hemoglobin levels, tumor markers (CA 125, CA 15.3 and CA 19.9) leels, and serum cytokine levels were evaluated. RESULTS: When evaluating IL-6, it was observed that higher serum levels were associated with overall survival less than 60 months (p = 0.0382). In the evaluation of IL-8, higher serum levels were associated with RNL≥4 and RPL≥200 (p = 0.0198 and = 0.0072, respectively), altered values of serum CA125 (p = 0.0457), and stage IIIC (p = 0.0486). CONCLUSION: There is a relation of the increase of cytokines with factors of worse prognosis in ovarian cancer, especially IL-6 and IL-8. Further studies with a larger sample of patients are needed to confirm the role of cytokines as prognostic factors and in the definition of treatment and in the perspective of future target therapies.