title: Elevated serum interleukin-37 level is a predictive biomarker of poor prognosis in epithelial ovarian cancer patients.
abstract: OBJECTIVE
  Interleukin-37 (IL-37) has been identified as a novel anti-inflammatory cytokine which is involved in tumor development. This study aimed to evaluate the expression of IL-37 in serum and determine its clinical significance in human epithelial ovarian cancer (EOC).
  
  
  METHODS
  Enzyme-linked immunosorbent assay (ELISA) was performed to examine the serum IL-37 levels in 76 patients with EOC and 76 healthy controls. The association of IL-37 levels with clinical factors and prognosis of EOC patients was analyzed. The diagnostic accuracy of serum IL-37 was performed by receiver operator characteristic (ROC) curve analysis.
  
  
  RESULTS
  Serum IL-37 levels in patients with EOC (187.3 ± 75.57 pg/ml) were significantly higher than those in healthy controls (84.89 ± 28.92 pg/ml, P < 0.001). High serum IL-37 levels were significantly associated with FIGO stage (P < 0.001), tumor size (P = 0.002), lymph node metastasis (P = 0.021), positive recurrence (P = 0.047) and residual tumor size (P < 0.001). The Kaplan-Meier survival analysis demonstrated that high serum IL-37 levels were significantly associated with poor overall survival and the progression-free survival (log-rank, P = 0.026, and P = 0.039, respectively). Univariate and multivariate analysis indicated that serum IL-37 levels (HR = 3.007, 95% CI 2.125-4.842, P = 0.008) were an independent prognostic factor for EOC patients. ROC curve analyses revealed an AUC (the areas under the ROC curve) of 0.881 (95% CI 0.829-0.945; P < 0.001).
  
  
  CONCLUSIONS
  High serum IL-37 levels are associated with an unfavorable prognosis of EOC patients. IL-37 may serve as a promising and useful prognostic biomarker for EOC.
authors.affiliation: Department of Gynaecology and Obstetrics, The First Hospital of Yulin, Yulin, Shaanxi, 718000, China.
authors.forename: Junwei
authors.initials: J
authors.lastname: Huo
authors.affiliation: Department of Gynaecology and Obstetrics, Xi'an Central Hospital, Xi'an, Shaanxi, 710003, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Gynaecology and Obstetrics, The First Hospital of Yulin, Yulin, Shaanxi, 718000, China.
authors.forename: Gaowei
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Gynaecology and Obstetrics, Xi'an No 1. Hospital, Xi'an, Shaanxi, 710003, China.
authors.forename: Yajie
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Gynaecology and Obstetrics, Tangdu Hospital, The Fourth Military Medical University, No 1, Xinsi Road, Baqiao District, Xi'an, Shaanxi, 710038, China. eager_ju@sina.com.
authors.forename: Ying
authors.initials: Y
authors.lastname: Ju
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D000077216:Carcinoma, Ovarian Epithelial; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000097:blood*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood* / Q000401:mortality / Q000473:pathology; D010051:Ovarian Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; C508587:IL37 protein, human; D007375:Interleukin-1
keywords: Biomarker; Epithelial ovarian cancer; Interleukin-37; Prognosis