Comparative estimation of serum osteopontin tumor necrosis factor-alpha and IL-6 as an indictor for immune dysregulation in nasopharyngeal carcinoma

The present study was designed to evaluate serum levels of osteopontin [OPN], tumor necrosis factor-alpha [TNF-alpha] and interleukin-[IL]-6 in pre-treatment samples obtained from patients with biopsy confirmed nasopharyngeal carcinoma [NPC]. The study included 28 NPC patients; 20 males and 8 females with mean age of 56.8 +/- 8 years. Cervical lymphadenopathy was the main presenting symptom in 19 patients [67.9%], recurrent unexplained attacks of epistaxis in 16 patients [57.1%] and 7 patients [25%] had secretory otitis media. Patients were clinically categorized using TNM staging and underwent nasopharyngoscopy and biopsy taking for pathological examination and grading according to the World Health Organization [WHO] types. All patients received chemo-radiotherapy and completed their follow-up at ENT outpatient clinic. Pre-and post-treatment blood samples were collected for estimation of serum level of osteopontin [OPN], tumor necrosis factor-a [TNF-alpha] and interleukin-[lL]-6. Blood samples were obtained from 10 healthy volunteers as control group. Pretreatment serum levels of estimated parameters were significantly higher compared both to control levels and to post-treatment levels. However, despite treatment induced significant decrease of serum levels of estimated parameters, their levels still significantly higher compared to control levels. There was a positive significant correlation between TNM clinical staging and serum levels of OPN, TNF alpha and IL-6, Also, WHO pathological types showed a positive significant correlation with serum levels of OPN and lL-6, but the correlation with TNF-alpha was positive non-significant. Using ROC analysis for estimated parameters as screening test for WHO type I lesions defined estimation of serum OPN as a good screening test to detect early lesions and defined 2 cutoff points for serum OPN; namely: 265 and 298 ng/ml, had identical screening power however, cutoff point at 265 ng/ml showed significantly higher of sensitivity rate [89.3%]. NPC is associated with immune dysregulation in favor of Th1 side and elevated OPN pre-treatment serum levels that could be used as screening test for early cases of NPC as a preliminary screening test with cutoff point at 265 ng/ml as discriminative value

Serum risk markers as predictors of cardiac and renal complications in patients with obstructive sleep apnea

Patients with obstructive sleep apnea are at high risk to develop many complications. Increased risk to develop cardiovascular and renal morbidity and mortality are the most sinister of these complications. There are various serum markers which are known to be helpful as prognostic factors for the development of cardiac and renal complications in those patients. The aim of this study is to determine the prognostic value of certain serum cardiac and renal risk markers in OSA. The study also aims to investigate the relationship between the serum level of these markers and severity of OSA. Forty five males were included in this study, classified into two groups, the obstructive sleep agroup [n=30], this group subdivided into two subgroups with respect to apnea-hypopnea index [AHl]: subgroup A, [n=15], with AHI<5; and subgroup B [n=15], with AHI >5. The second group included [n=15] healthy control male subjects. All patients of obstructive sleep apnea group underwent overnight polysomonography after complete ENT examination. The serum level of cholesterol, triglycerides, C-reactive protein [CRP], homocysteine, creatinine, cystatin C were measured in both groups. Statistical significance was assessed with analysis of variance at p<0.05. In correlation analysis, pearson correlation was used. The results of over night polysomonography were significantly diagnostic for OSA in all patients of the OSA patients' group. There was significant difference-regarding serum levels of homocysteine, CRP and cystatin C in OSA patients' group compared to the control group. Serum homocysteine, CRP and cystatin C levels were significantly increased in subgroup B compared to subgroup A [p<0.05]. There was no significant difference between OSA patient's group and the control group and between subgroup A and subgroup B in serum creatinine, total cholesterol, LDL-C, HDL-C, triglyceride. Increased plasma concentrations of homocysteine and CRP can he useful in clinical practice as predictors for cardiovascular disease in patients with OSA. Also increased plasma level of cystatin C is a predictor of impaired renal function in OSA patients and it is more sensitive than serum creatinine