Clinicopathologic significance of cytokine levels in esophageal squamous cell carcinoma.

Background/aims: Treatment's effect on esophageal squamous cell carcinoma (ESCC) patients' immune functions may influence outcomes. Here, we address the scarcity of information about immune responses of treated and untreated ESCC patients.

Methodology: Levels of IFN-gamma, TNF-alpha, IL-2, IL-4, IL-5 and IL-10 were detected in 36 untreated patients (UPs), and 82 treated patients (TPs) with ESCC, and in 70 healthy controls, using cytometric bead arrays.

Results: Levels of IL-2, IL-4 and IL-5 were higher (p < 0.001), and TNF-alpha was lower (p < 0.01), in UPs than in controls; IFN-gamma, IL-2, IL-4, IL-5 and IL-10 levels were higher in TPs than in controls (p < 0.001); IFN-gamma, TNF-alpha and IL-10 levels were higher in TPs than in UPs (p < 0.05); IFN-gamma/IL-4 ratios of UPs were lower than controls (p < 0.05). Levels did not significantly differ by age or weight index, but did differ by clinical stages, differentiation degree and tumor location. Patients' survival was affected by clinical stage (p = 0.001), differentiation degree (p = 0.012), tumor location (p = 0.043) and lymph node involvement (p = 0.039); clinical stage was an independent prognostic factor (p = 0.014).

Conclusions: We found that Th1/Th2 imbalance and immune function turbulence correlate with differentiation degree, clinical stage and tumor location. Moreover, clinical stage is currently the best predictor of survival.