Investigating the correlation between cytokine levels and prognostic factors in advanced gastric cancer: A systematic review and meta-analysis.

BACKGROUND

Advanced gastric cancer (AGC) aggressiveness and poor prognosis necessitate understanding its molecular drivers. Cytokines in the tumor microenvironment influence tumor behavior, and this study aims to analyze their expression levels and correlate them with clinical outcomes in AGC patients to enhance prognostic understanding.

METHOD: Original studies evaluating cytokine levels in AGC were searched in PubMed and Google Scholar databases up to October 31, 2023. Survival outcomes post-treatment, including five-year survival rates, were analyzed using RevMan 5.4.1, with a focus on OS, PFS, metastasis, and tumor stage for further evaluation.

RESULTS

The results indicate a significant association between IL-17 and improved PFS in individuals with AGC (P < 0.00001). However, no statistically significant effects were observed for IL-2 (P = 0.22), IL-4 (P = 0.39), IL-10 (P = 0.22), IL-6 (P = 0.14), and IFN-gamma (P = 0.85), on PFS. Notably, IL-17 (P < 0.00001) and IL-6 (P < 0.00001) were found to have a substantial impact on OS in AGC patients. Conversely, the overall effect test did not show significance for IFN-gamma on OS (P = 0.95). Furthermore, there were no significant differences in IL-10 and IL-17 expression detected between AGC patients with and without metastasis (P = 0.64 and 0.11), nor in IL-6 levels between advanced (III-IV) and early stage (I-II) patients(P = 0.13).

CONCLUSION

Elevated levels of IL-17 were linked to shorter PFS in AGC. Both IL-17 and IL-6 affected OS significantly, with higher levels associated with poorer OS outcomes, while other cytokines did not. Further research is needed on the prognostic role of cytokines in AGC.

STUDY REGISTRATION: Prospero ID(CRD42024556571).