Year: 2024 | Month: June | Volume: 11 | Issue: 6 | Pages: 844-851
DOI: https://doi.org/10.52403/ijrr.20240691
High Levels of Interleukin-6, Vascular Endothelial Growth Factor, And High Expression Of B-Cell Lymphoma 2 as Risk Factors for Bone Metastasis in Lung Cancer Patients
I Gusti Agung Wiksa Astrayana1, Prof. Dr. I Ketut Suyasa2, Dr. I Gede Eka Wiratnaya2, Dr. I Wayan Juli Sumadi3
1Resident of Orthopedic and Traumatology Department, Prof Ngoerah General Hospital, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
2Consultant of Orthopedic and Traumatology Department, Prof Ngoerah General Hospital, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
3Consultant of Pathology Anatomy Department, Prof Ngoerah General Hospital, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
Corresponding Author: I Gusti Agung Wiksa Astrayana
ABSTRACT
Introduction: Bone metastasis is malignancy originates from other cancers and accounts for an estimated 70% of bone malignancy cases. Previous studies have found that the incidence of bone metastasis cases in lung cancer patients is approximately 16.89% of the total patients. In Indonesia, lung cancer ranks among the top three cancers with a 5-year prevalence rate reaching 13.77 per 100,000 population in 2018. Interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), and B-cell lymphoma 2 (Bcl-2) have been extensively studied and potential as predictors of bone metastasis occurrence in lung cancer patients. Researcher aimed to determine whether high levels of IL-6, VEGF, and Bcl-2 expression are risk factors for bone metastasis in lung cancer patients.
Methods: This study involved 40 lung cancer patients at Prof. Dr. I.G.N.G. Ngoerah General Government Hospital. It included 20 patients lung cancer with metastatic bone disease as the case group and 20 patients lung cancer without metastatic bone disease as the control group. Data on IL-6, VEGF, and Bcl-2 expression levels were collected from patients in both groups and statistically analyzed to determine whether these parameters are risk factors for bone metastasis in lung cancer patients.
Results: In bivariate analysis, this study shows that high levels of IL-6, high levels of VEGF, and high expression of Bcl-2 are statistically significant risk factors for bone metastasis in lung cancer patients (ORIL-6=107,67(10,21-1135,59); ORVEGF= 76,0(7,69-750,49); ORBcl-2=22,67(4,37-117,47), p=<0.001). Multivariate analysis showed that IL-6 levels and Bcl-2 expression were the most influential risk factors for bone metastases in lung cancer patients (AORIL-6=6,78, p=0,038; AORBcl-2=13,78, p=0,003).
Discussion: This study proves that high levels of IL-6, high levels of VEGF, and high expression of Bcl-2 are risk factors for bone metastasis in lung cancer patients. This study showed minimal confounding factors as there were no differences in characteristics between the two groups. However, if all three factors are present in a patient at the same time, the most influential factors are the levels of IL-6 and Bcl-2.
Conclusion: High levels of IL-6, high levels of VEGF, and high expression of Bcl-2 are risk factors for bone metastasis in lung cancer patients.
Level of Evidence: III B
Keywords: IL-6 levels, VEGF levels, Bcl-2 expression, bone metastasis, lung cancer
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