title: Low serum interleukin-6 levels as a predictive marker of recurrence in patients with hepatitis B virus related hepatocellular carcinoma who underwent curative treatment.
abstract: BACKGROUND
  We aimed to investigate the use of novel serum biomarkers for predicting the recurrence and survival of patients with hepatitis B virus (HBV)-related early hepatocellular carcinoma (HCC) after hepatic resection or radiofrequency ablation (RFA).
  
  
  METHODS
  One hundred and five patients with HBV-related HCC, who fulfilled the Milan criteria without vascular invasion and underwent hepatic resection or RFA, were followed-up for a median duration of 52months. Pretreatment serum concentrations of 16 cytokines including interleukin-6 (IL-6) were measured by using a Luminex 200 system. The measured serum cytokines and several clinical factors were analyzed retrospectively.
  
  
  RESULTS
  Univariate analysis showed that patients with lower pretreatment serum levels of IL-10, IL-6, monocyte chemoattractant protein-1, and tumor necrosis factor-α had significantly shorter disease-free survival (DFS) than those with higher levels. Multivariate analysis revealed that a low serum IL-6 level (⩽33.00pg/mL; hazard ratio [HR]=5.39; 95% confidence interval [CI]=1.27-22.93; P=0.022), low platelet count (<100×10(9)/L; HR=2.23; 95% CI=1.28-3.89; P=0.005), and low serum albumin level (⩽3.5g/L; HR=2.26; 95% CI=1.28-3.97; P=0.005) had a negative prognostic impact on DFS. In the analysis for overall survival, a low serum platelet level (<100×10(9)/L; HR=2.80; 95% CI=1.31-5.99; P=0.008) and multiple tumor (⩾2; HR=4.05; 95% CI=1.56-10.48; P=0.004) showed a negative prognostic impact on the overall survival.
  
  
  CONCLUSIONS
  A low serum IL-6 level is, in addition to low platelet count and low serum albumin level, an independent prognostic factor for DFS in patients with HBV-related early HCC who underwent hepatic resection or RFA with curative intention.
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Hyo Jung
authors: HJ
authors: Cho
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Soon Sun
authors: SS
authors: Kim
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Seun Joo
authors: SJ
authors: Ahn
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Sun Young
authors: SY
authors: Park
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Joo Han
authors: JH
authors: Park
authors: Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Jae Keun
authors: JK
authors: Kim
authors: Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Hee Jung
authors: HJ
authors: Wang
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Jae Youn
authors: JY
authors: Cheong
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: sung_woncho@hotmail.com.
authors: Sung Won
authors: SW
authors: Cho
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000601:surgery / Q000821:virology*; D017115:Catheter Ablation; D018572:Disease-Free Survival; D005260:Female; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood* / Q000601:surgery / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000097:blood; D011379:Prognosis; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; C508600:IL6 protein, human; D015850:Interleukin-6
keywords: Cytokine; Hepatitis B, chronic; Hepatocellular carcinoma; Prognosis