title: Cytokines are associated with postembolization fever and survival in hepatocellular carcinoma patients receiving transcatheter arterial chemoembolization.
abstract: OBJECTIVE
  Cytokines play important roles in angiogenesis, inflammation, and cell growth. The present study aimed to investigate the correlation between cytokine changes and clinical characteristics in hepatocellular carcinoma (HCC) patients receiving transcatheter arterial chemoembolization (TACE).
  
  
  METHODS
  Forty-one TACE-näive HCC patients receiving 73 sessions of TACE and 30 healthy controls were studied. Serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), angiogenin, epidermal growth factor (EGF), epidermal growth factor receptor, and transforming growth factor β1 (TGF-β1) before and at 1, 3, 5, 7, and 14 days after TACE as well as clinical parameters were analyzed.
  
  
  RESULTS
  Baseline serum levels of VEGF, bFGF, IL-6, IL-8, and TNF-α in HCC patients were significantly elevated, whereas EGF and TGF-β1 levels were lower compared to those in healthy controls (p < 0.05 for all). Serum IL-6 increased rapidly and peaked on day 1 after TACE administration, whereas VEGF increased more slowly and peaked on day 14 after TACE administration. Patients with post-TACE fever had higher serum IL-6 levels on days 1, 3, and 5 (p < 0.005 for all). Patients with pre-TACE serum VEGF < 200 pg/ml had a longer survival than those with pre-TACE serum VEGF levels ≥ 200 pg/ml (22.2 months vs. 11.6 months, p = 0.014). Cox multivariate analysis showed that baseline serum VEGF significantly predicted survival for HCC patients receiving TACE.
  
  
  CONCLUSIONS
  TACE is associated with the modulation of serum angiogenic, inflammatory, and cell growth cytokines in HCC patients. Serum IL-6 correlates with post-TACE fever, and baseline serum VEGF independently predicts patient survival.
authors.affiliation: Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan.|National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Yee
authors.initials: Y
authors.lastname: Chao
authors.affiliation: Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.|Department of Dermatology, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Chen-Yi
authors.initials: CY
authors.lastname: Wu
authors.affiliation: National Yang-Ming University School of Medicine, Taipei, Taiwan.|Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 11217, Taiwan.
authors.forename: Chen-Yu
authors.initials: CY
authors.lastname: Kuo
authors.affiliation: National Yang-Ming University School of Medicine, Taipei, Taiwan.|Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 11217, Taiwan.
authors.forename: Jack P
authors.initials: JP
authors.lastname: Wang
authors.affiliation: National Yang-Ming University School of Medicine, Taipei, Taiwan.|Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 11217, Taiwan.
authors.forename: Jiing-Chyuan
authors.initials: JC
authors.lastname: Luo
authors.affiliation: National Yang-Ming University School of Medicine, Taipei, Taiwan.|Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 11217, Taiwan.
authors.forename: Chien-Hui
authors.initials: CH
authors.lastname: Kao
authors.affiliation: National Yang-Ming University School of Medicine, Taipei, Taiwan.|Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Rheun-Chuan
authors.initials: RC
authors.lastname: Lee
authors.affiliation: National Yang-Ming University School of Medicine, Taipei, Taiwan.|Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Lee
authors.affiliation: National Yang-Ming University School of Medicine, Taipei, Taiwan. cpli@vghtpe.gov.tw.|Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 11217, Taiwan. cpli@vghtpe.gov.tw.
authors.forename: Chung-Pin
authors.initials: CP
authors.lastname: Li
keywords: Hepatocellular carcinoma; Interleukin-6; Transcatheter arterial chemoembolization; Vascular endothelial growth factor