title: In patients with colorectal cancer, preoperative serum interleukin-6 level and granulocyte/lymphocyte ratio are clinically relevant biomarkers of long-term cancer progression.
abstract: OBJECTIVE
  To investigate the clinical significance of the serum inflammatory cytokines and the blood granulocytes/lymphocytes (G/L) ratio in patients with colorectal cancer.
  
  
  METHODS
  Forty-six patients underwent surgery for colorectal cancer. The G/L ratio and serum inflammatory cytokines including interleukin (IL)-1β, IL-6, IL-8, tumour necrosis factor-α (TNF-α), granulocyte colony-stimulating factor and macrophage colony-stimulating factor (M-CSF) were measured before surgery and correlated with the Tumour Node Metastasis classification and overall survival.
  
  
  RESULTS
  Serum IL-6 in T3-4, N1-2, M1 cases and cancer stages III-IV sub-groups was significantly higher than in Tis-2, N0, M0 and cancer stages 0-II sub-groups. The G/L ratio, serum M-CSF and TNF-α in T3-4 cases were significantly higher than in Tis-2 cases. Furthermore, the G/L ratio and serum IL-6 showed a significant inverse correlation with the overall survival, while the G/L ratio showed a significant positive correlation with serum IL-6, TNF-α and M-CSF. Multivariate analysis showed that the serum IL-6 level and G/L ratio were independent risk factors for poor prognosis.
  
  
  CONCLUSIONS
  In this investigation, a pre-operative high level of serum IL-6 and the G/L ratio appeared to be significant predictive factors for cancer progression and poor prognosis. Accordingly, these variables might be clinically relevant biomarkers in patients with colorectal cancer.
authors.affiliation: Fourth Department of Surgery, Tokyo Medical University, Ami, Japan. shima-j @ tokyo-med.ac.jp
authors.forename: Jiro
authors.initials: J
authors.lastname: Shimazaki
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Goto
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Nishida
authors.forename: Takanobu
authors.initials: T
authors.lastname: Tabuchi
authors.forename: Gyo
authors.initials: G
authors.lastname: Motohashi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ubukata
authors.forename: Takafumi
authors.initials: T
authors.lastname: Tabuchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D015179:Colorectal Neoplasms / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D018450:Disease Progression; D005260:Female; D006098:Granulocytes; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D018655:Lymphocyte Count; D008214:Lymphocytes; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D018709:Statistics, Nonparametric; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D014408:Biomarkers, Tumor; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016173:Macrophage Colony-Stimulating Factor