Pretreatment Nutrition-Inflammation Biomarkers Correlated with Differential Cytokine Profiles in Taiwanese Patients with Colorectal Cancer

Abstract

Systemic inflammation plays a pivotal role in colorectal cancer (CRC) development. Two hallmarks reflect the severity of inflammation—circulating cytokines and nutrition-inflammation biomarkers (NIBs); however, their interplay has not been fully investigated. In total, 128 CRC patients were included. Ten circulating cytokines (TNF-α, TGF-β, IFN-γ, IL-1β, IL-4, IL-6, IL-10, IL-12, IL-13, and IL-23) and NIBs were analyzed. The relationship between cytokines, NIBs, clinicopathological variables, and overall survival (OS) was assessed using univariate and multivariate analyses. Three NIBs (CRP-to-albumin ratio [CAR]), neutrophil-to-lymphocyte ratio [NLR]), and prognostic nutritional index [PNI]) were associated with OS in univariate analysis; however, CAR was better for OS prediction in multivariate analysis (P = 0.015). None of the serum cytokines analyzed showed a significant association with OS. High CAR (≥0.25) and high IL-10 (≥76.6 pg/mL), high NLR (≥8.2) and high IL-23 (≥51.2 pg/mL), and high PNI (≥42.4) and high IL-1β (≥14.3 pg/mL) values were correlated. CAR, NLR, and PNI were not correlated with each other, whereas circulating cytokines were closely interrelated. High CAR was an independent predictor of poor OS in patients with CRC. Different NIBs have unique cytokine profiles, but show no correlation with each other. There is a close association among the circulating cytokines.

Acknowledgments

We thank the Tissue Bank and Biobank, Chang Gung Memorial Hospital, Keelung for providing the study material.

Author Contributions

KYY was responsible for designing the study protocol, conducting the research, interpreting the results and revising the entire manuscript. YLY organized the original data and drafted the entire manuscript. WKT conducted statistical analysis and generated Table 1. CWF collected demographic data and generated Table 2. PHC analyzed the survival data and generated Table 3, Figure 1 and revised the final version of the Introduction and Discussion. HCK provided scholarly interpretation and revised part of the Discussion. YPP contributed to data extraction and background information. All authors critically revised, read, and approved the final manuscript, and agreed to be fully accountable for ensuring the integrity and accuracy of the work.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Chung Gang Memorial Hospital, Keelung (Taiwan) under Grants (CGRPG2F0061 and CMRPG2J0041).