Role of IL-6 and VEGF in epithelial ovarian cancer

Abstract

Introduction: Over the last two decades there is a trend toward increasing incidence of ovarian cancer cases. CA-125 and some other tumor markers are known to have prognostic importance. Some cytokines have also been studied for their role in prognosis; IL-6 and VEGF are among them. It is hypothesized that these cytokines might affect the clinical progression of patients with ovarian cancer. Aim and Objectives: To measure and correlate the effect of levels of IL-6 and VEGF in ascitic fluid on presentation, treatment response and outcome in patients with epithelial carcinoma ovary and to determine whether levels of IL-6 significantly correlate with progression-free survival. Materials and Methods: Thirty patients with epithelial ovarian carcinoma and 15 patients who were undergoing hysterectomy for benign condition were recruited. Once patients found fit for study, they were taken up for primary debulking surgery. Ascitic fluid was collected and sent for measuring IL 6 and VEGF levels. Peritoneal washings taken from patients posted for total abdominal hysterectomy for benign pathology was used as control to achieve the values of IL-6 and VEGF in the study population. Patients were followed up for 1 year after surgery with ultrasound abdomen and pelvis and serum CA 125 levels. Results: Median value of IL-6 in ascetic fluid was 8563.18 pg/ml in EOC cases and 17 pg/ml in benign pathology group and of VEGF was 6090.35 pg/ml and 34.01 pg/ml, which were found to be significantly higher in cases compared to control group (p = 0.0001). Levels of VEGF was significantly higher in patients with positive ascitic fluid cytology (p = 0.009) and ascitic fluid volume >1L (p = 0.021). Correlation of VEGF and IL6 levels with other prognostic was not statistically significant. Levels of IL-6 and VEGF in ascitic fluid did not correlate statistically with survival time or with recurrence (p = 0.651). Conclusion: Levels of VEGF in ascitic fluid were found to correlate with ascitic fluid cytology and volume but not with FIGO stage, histological grade, histological type, tumor size, residual tumor, CA 125 levels, chemotherapy response, presentation and with overall outcome and survival time. None of the above mentioned prognostic factors were found to correlate with levels of IL-6 in ascitic fluid.