Serum interleukin-6 and C-reactive protein as a prognostic indicator in hepatocellular carcinoma

• Published in: Cytokine (Philadelphia, Pa.) Vol. 60; no. 3; pp. 686 - 693
• Main Authors: Jang, Jeong Won, Oh, Byong Sun, Kwon, Jung Hyun, You, Chan Ran, Chung, Kyu Won, Kay, Chul Seung, Jung, Hyun Suk
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2012
• Subjects: analysis; Antineoplastic Combined Chemotherapy Protocols; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological markers; biomarkers; Biomarkers, Tumor; Biomarkers, Tumor - blood; blood; blood serum; C-reactive protein; C-Reactive Protein - analysis; Carcinogenesis; Carcinoma, Hepatocellular; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - radiotherapy; Cisplatin; Cisplatin - therapeutic use; Doxorubicin; Doxorubicin - therapeutic use; drug therapy; Enzyme-linked immunosorbent assay; Epirubicin; Epirubicin - therapeutic use; Female; Helper cells; Hepatocellular carcinoma; hepatoma; Humans; Inflammation; Interleukin 10; Interleukin 6; Interleukin-10 - blood; Interleukin-4; Interleukin-4 - blood; Interleukin-6 - blood; Liver Neoplasms; Liver Neoplasms - blood; Liver Neoplasms - drug therapy; Liver Neoplasms - radiotherapy; Lymphocytes T; Male; Middle Aged; Multivariate analysis; patients; Prognosis; radiotherapy; Survival; therapeutic use; therapeutics; Tumors; CRP; IL; C-reactive protein; Prognosis; HCC; Hepatocellular carcinoma; AFP; PVT; Interleukin-6; IFN-γ; TNF-α; HCV; Biological markers; HBV
• ISSN: 1043-4666; 1096-0023; 1096-0023
• DOI: 10.1016/j.cyto.2012.07.017

► There is the presence of increased Th2-cytokine patterns in patients with HCC compared to healthy controls. ► IL-6 is an independent predictor of survival in patients with HCC treated with loco-regional therapy. ► CRP and IL-6 are linked to both tumor burden and hepatic reserve function. ► The changes in CRP levels provide a good predictive capacity of tumor response. The development of hepatocellular carcinoma (HCC) is often associated with chronic inflammation, suggesting a strong relationship between inflammation and carcinogenesis. This study evaluated the prognostic values of inflammatory and T-helper (Th) cytokines in the clinical outcome and survival of HCC. The study included 110 patients with HCC undergoing loco-regional therapy and 24 healthy controls. Five Th1/Th2 cytokines and C-reactive protein (CRP) were quantified before and after loco-regional treatment, using enzyme-linked immunosorbent assays. Levels of CRP, interleukin (IL)-4, and IL-6 were higher in patients with HCC than those in healthy subjects. Tumor characteristics, Child-Pugh class, and CRP, IL-6, and IL-10 levels were associated with HCC survival (all P<0.05). With multivariate analysis, higher IL-6 levels were identified as the independent cytokine for shorter survival (P=0.010). Higher CRP and IL-6 levels correlated well with larger tumor size, poor Child-Pugh function, and shorter survival, with a significant inter-correlation (r=0.667). On serial measurements, the association of CRP with tumor response was stronger than that of α-fetoprotein or other cytokines. IL-6 and CRP are strong inflammatory indicators predictive of outcome in patients with HCC receiving loco-regional therapy. This study suggests that inflammatory activation of the IL-6/CRP network may be a potential therapeutic target and biomarker for HCC.