title: Circulating interleukin-6 as a tumor marker for hepatocellular carcinoma.
abstract: BACKGROUND
  A large amount of evidence suggests a possible role of interleukin-6 (IL-6) in the pathogenesis of hepatocellular carcinoma (HCC).
  
  
  METHODS
  We studied both IL-6 and A(1)FP in patients with HCC, non-neoplastic liver disease or in healthy controls.
  
  
  RESULTS
  IL-6 titers were four-fold higher in cancer than in cirrhotic patients and 25-fold higher than in healthy controls. As for alpha1-fetoprotein (A(1)FP) titers, the highest levels were observed in cancer patients. Receiver operating characteristic (ROC) curves analysis demonstrated that IL-6 is significantly more discriminant than A(1)FP, with 'optimal' cut-off values of 7.9 pg/ml (sensitivity = 0.83, specificity = 0.83, efficiency = 0.83). The ROC curves used to distinguish HCC from cirrhotic patients only, showed higher discriminant power of IL-6 versus A(1)FP titers, with a new cut-off value of 12 pg/ml (sensitivity = 0.73, specificity = 0.87, efficiency = 0.8). Discriminant analysis on HCC and non-HCC subjects yielded sensitivity, specificity and efficiency rates of 77%, 93% and 88%, respectively. The overall efficiency of the two tests combined was 82%.
  
  
  CONCLUSIONS
  IL-6 could be considered a promising tumor marker for HCC. In particular, the diagnostic value of the test is significantly increased when combined with A(1)FP.
authors.affiliation: Internal Medicine and Medical Oncology, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo University Hospital Foundation, Pavia, Italy. c.porta@smatteo.pv.it
authors.forename: C
authors.initials: C
authors.lastname: Porta
authors.forename: M
authors.initials: M
authors.lastname: De Amici
authors.forename: S
authors.initials: S
authors.lastname: Quaglini
authors.forename: C
authors.initials: C
authors.lastname: Paglino
authors.forename: F
authors.initials: F
authors.lastname: Tagliani
authors.forename: A
authors.initials: A
authors.lastname: Boncimino
authors.forename: R
authors.initials: R
authors.lastname: Moratti
authors.forename: G R
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000401:mortality / Q000473:pathology; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000097:blood / Q000401:mortality / Q000473:pathology; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood / Q000401:mortality / Q000473:pathology; D008113:Liver Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D012372:ROC Curve; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D015850:Interleukin-6; D000509:alpha-Fetoproteins