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-γ, TNF-α, 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-α was lower (p<0.01), in UPs than in controls; IFN-γ, IL-2, IL-4, IL-5 and IL-10 levels were higher in TPs than in controls (p<0.001); IFN-γ, TNF-α and IL-10 levels were higher in TPs than in UPs (p<0.05); IFN-γ/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.