Expression analysis of cytokines IL-22, IL-17, IL-6, IL-8, and TNF-α in patients with lung cancer and lung cancer complicated with COPD

Abstract

To explore the clinical significance and prognostic value of changes in cytokines ( IL-22, IL-17, IL-6, IL-8, TNF-α ) concentrations in peripheral blood in patients with pure lung cancer and lung cancer complicated with chronic obstructive pulmonary disease (LC-COPD). 93 patients in the pure lung cancer group and 57 patients in the LC-COPD group. General patient clinical information was collected and patients with LC-COPD group were graded for disease severity. Cytokines IL-22, IL-17, IL-6, IL-8, and TNF-α levels were determined in the two groups by liquid chip technology. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic potential of these markers. The associations between the cytokines and patients’ clinicopathological parameters were assessed using the Wilcoxon rank-sum test and Spearman’s correlation analysis. Compared with the pure lung cancer group, the levels of IL-22 , IL-17 , IL-6 , IL-8 and TNF-α in patients in the LC-COPD group were increased. In pure lung cancer group, only IL-6 and IL-8 correlated with stage, smoking, and lymph node metastasis; in the LC-COPD group, IL-6, IL-8, and TNF-α correlated with stage, smoking, and lymph node metastasis. In LC-COPD group, the levels of IL-6 , IL-8 , and TNF-α significantly increased with rising GOLD severity classification ( P  < 0.05). Correlation analysis revealed that IL-6, IL-8 , and TNF-α levels were negatively correlated with FEV1% and FEV1/FVC%. ROC analysis demonstrated that IL-6 (AUC: 0.72), IL-8 (AUC: 0.66), TNF-α (AUC: 0.70), and the combined five cytokines (AUC: 0.82) exhibited excellent diagnostic performance in the differential diagnosis between pure lung cancer and LC-COPD. Regarding prognostic prediction, IL-6 (AUC: 0.78), IL-8 (AUC: 0.85), TNF-α (AUC: 0.75), and the combined five cytokines (AUC: 0.89) demonstrated superior predictive efficacy for the prognosis of patients with LC-COPD. Kaplan–Meier survival analysis indicated that LC-COPD patients with high IL-6, IL-8 , and TNF-α expression had significantly poorer prognosis ( P  < 0.05). This study demonstrates that IL-6 , IL-8 , and TNF-α are associated with higher TNM stages in pure lung cancer and LC-COPD, and serve as potential biomarkers for pulmonary function impairment, tumor progression and prognosis in LC-COPD. Furthermore, the combination of these five cytokines exhibited high efficacy for both the differential diagnosis of lung cancer and LC-COPD and the prediction of LC-COPD prognosis.