Objectives Cancer patients with increased stress have worse quality of life and survival. Stress hormones such as cortisol also contribute to suppressed immune function. Stress hormones, immune cells and cytokines are evaluable in the ascites of patients with advanced stage high grade serous epithelial ovarian cancer (HGSOC). We determined the relationship between cortisol and cytokines in ascites from patients with HGSOC.

Methods Clinicodemographic information and ascites from 66 patients with primary or recurrent HGSOC were collected. Cortisol concentration was measured by ELISA using Parameter™ Cortisol. Milliplex® MAP Human Cytokine/Chemokine Magnetic bead panel was utilized to measure cytokine levels. Significance was determined using linear regression using p<0.05.

Results Cortisol was positively correlated with IL-7 (slope=0.2782, 95% CI:0.03742–0.5189), which is a known contributor to invasiveness and metastasis of cancer. G-CSF (associated with tumor growth, angiogenesis and poor prognosis) was associated with elevated cortisol levels (slope=3.581, 95% CI:1.203–5.959). Conversely, cortisol was negatively correlated with cytokines that promote immune response. This included FGF-2 (slope=-0.8821, 95% CI:-1.703-(-0.06101)) and IP-10 (slope=-32.44, 95% CI:-60.07-(-4.817)), a chemokine that plays a role in recruiting activated T cells to inflammatory sites.

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Abstract EPV188/#270 Figure 1

Conclusions Our data suggest increased ascites-derived cortisol from patients with HGSOC is associated with higher levels of IL-7 and G-CSF, cytokines that promote tumor growth. Higher levels of ascites-derived cortisol correlated with lower levels of FGF-2 and IP-10, cytokines that enhance immune function. Ascites from HGSOC patients provide a window into how stress hormones impact tumor and immune cells.