Relationship between Levels of Interleukin-6 and Tumour Necrosis Factor Alpha and Khorana Scores of Newly Diagnosed Ambulatory Cancer Patients

Abstract

Abstract Background: In cancer microenvironment, there is increased production of inflammatory cytokines, including tumour necrosis factor (TNF)-α, interleukin (IL)-1a, and IL-6. These cytokines are capable of causing thrombus formation through the activation of tissue factors. Then, the Khorana risk score can be Utilised to stratify the risk of venous thromboembolism in cancer patients. Aim: The objective of this study was to determine the relationship between levels of IL 6, TNF-α, and Khorana scores of chemotherapy-naïve ambulatory cancer patients (CNACPs). Materials and Methods: This was a cross-sectional study. The case group (n = 100) consisted of newly diagnosed CNACP recruited from adult oncology clinics of University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu, Nigeria, whereas the control group (n = 100) consisted of healthy individuals. The participants’ blood samples were assayed by enzyme-linked immunosorbent assay (ELISA) technique for IL-6 and TNF-α. Demographic variables were analysed using descriptive statistics in the form of frequencies and percentages and P < 0.05 was considered statistically significant. Results: There were significant differences between the mean levels of IL-6 (P = 0.036) and TNF-α (P = 0.001) in three Khorana score groups of the case group. Further, comparisons of mean IL-6 levels between three Khorana score groups showed that differences were between high-risk versus low-risk groups (P = 0.026) and between intermediate-risk versus low-risk groups (P = 0.014). Comparison of mean TNF-α levels in three Khorana score groups of CNACP showed that differences were between high-risk versus low-risk groups (P = 0.026) and between intermediate-risk versus low-risk groups (P = 0.014). Furthermore, there was a significant positive correlation between the Khorana scores and IL-6 (r = 0.28, P = 0.031) and TNF-α (r = 0.254, P = 0.011). The mean serum levels of IL-6 and TNF-α were significantly higher in CNACP than in healthy control (8.98 [8–12] pg/ml vs. 8.43 [2–10] pg/ml, P < 0.001) and (P < 0.001 and < 0.01), respectively. Conclusion: Inflammatory biomarkers are elevated in ambulatory CNACP and their values are significantly related with Khorana scores. There is a need for more studies on the possible benefit of prophylactic anticoagulation for newly diagnosed CNACP.