Serum interleukin-6 and C-reactive protein as a prognostic indicator in hepatocellular carcinoma.
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.
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. garden@catholic.ac.kr
Jeong Won
JW
Jang
Byong Sun
BS
Oh
Jung Hyun
JH
Kwon
Chan Ran
CR
You
Kyu Won
KW
Chung
Chul Seung
CS
Kay
Hyun Suk
HS
Jung
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000188:drug therapy / Q000532:radiotherapy; D002945:Cisplatin / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D015251:Epirubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D008113:Liver Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis
D014408:Biomarkers, Tumor; D015850:Interleukin-6; D016753:Interleukin-10; D015847:Interleukin-4; D015251:Epirubicin; D004317:Doxorubicin; D002097:C-Reactive Protein; D002945:Cisplatin