Background: Osteosarcoma (OS) is the most frequent primary malignant bone tumour, mainly affecting children in the first and second decade of life. Causes of the disease are still unknown and reaction of the immune system on its development is very individual. Particular emphasis must be placed on the role of cytokines in the immunoregulatory and coordinating function and tumour cell disruption. Knowledge about cytokines concentration in serum, regarding mechanisms of oncogenesis, may have prognostic significance for the further course of OS in children. The aim of study was evaluation of IL-2, IL-4, IL-8, IFN-gamma, and TNF-a concentrations in children with osteosarcoma at diagnosis.
Materials and methods: The study was performed on the group of44 children with osteosarcoma, aged from 6 to 20 years (average 14.9 years; median 15.0 years). 22 children ofthesame age (median 14.5years) without neoplastic disease and active inflammatory state formed the control group. Investigations were performed before the therapy. The inclusion criteria were: diagnosis of primary osteosarcoma, upper or lower limbs tumour localization, patients who were not treated by chemo- or radiotherapy before biopsy patients' age at diagnosis was 6-20 years. Concentrations of selected cytokines were analyzed in peripheral blood with using ELISA method with 99.8% sensitivity and 99,5% specificity.
Results: In children with osteosarcoma, at diagnosis the following concentration of peripheral blood cytokines (medians) was observed: IL-2 10.7 pg/ml (min-max: 0.0-894.0); IFN-gamma 1,3 pg/ml (min-max: 0.2-147); TNF-alpha 28.3 pg/ml (min-max: 0.0-188.8); IL-4 2.0 pg/ml (min-max: 0.0-32.0); IL-8 13.5 pg/ml (min-max: 0.0-2154.0). A large scatter among individual children results was found. Analysis of cytokines concentration showed significant statistical differences between patients with OS and the control group in case of IL-4 (p=0.005) and IL-8 (p=0.01).
Conclusions: Results of studies obtained at diagnosis did not give a specific answer about the prognosis and further course of OS disease in patients in the developmental age. Big differences in cytokines concentration in children and youth with OS might be associated with individual biological variation and individual reaction to the development of neoplastic disease and further studies in this direction are needed - before the start of cytostatic therapy and in therapy monitoring.