Elevated serum interleukin-37 level is a predictive biomarker of poor prognosis in epithelial ovarian cancer patients

Abstract

Purpose: Interleukin-37 (IL-37) has been identified as a novel anti-inflammatory cytokine which is involved in tumor development. This study aimed to evaluate the expression of IL-37 in serum and determine its clinical significance in human epithelial ovarian cancer (EOC).

Methods: Enzyme-linked immunosorbent assay (ELISA) was performed to examine the serum IL-37 levels in 76 patients with EOC and 76 healthy controls. The association of IL-37 levels with clinical factors and prognosis of EOC patients was analyzed. The diagnostic accuracy of serum IL-37 was performed by receiver operator characteristic (ROC) curve analysis.

Results: Serum IL-37 levels in patients with EOC (187.3 ± 75.57 pg/ml) were significantly higher than those in healthy controls (84.89 ± 28.92 pg/ml, P < 0.001). High serum IL-37 levels were significantly associated with FIGO stage (P < 0.001), tumor size (P = 0.002), lymph node metastasis (P = 0.021), positive recurrence (P = 0.047) and residual tumor size (P < 0.001). The Kaplan-Meier survival analysis demonstrated that high serum IL-37 levels were significantly associated with poor overall survival and the progression-free survival (log-rank, P = 0.026, and P = 0.039, respectively). Univariate and multivariate analysis indicated that serum IL-37 levels (HR = 3.007, 95% CI 2.125-4.842, P = 0.008) were an independent prognostic factor for EOC patients. ROC curve analyses revealed an AUC (the areas under the ROC curve) of 0.881 (95% CI 0.829-0.945; P < 0.001).

Conclusions: High serum IL-37 levels are associated with an unfavorable prognosis of EOC patients. IL-37 may serve as a promising and useful prognostic biomarker for EOC.

Keywords: Biomarker; Epithelial ovarian cancer; Interleukin-37; Prognosis.