外周血IL-6对早期肝癌微波消融后复发的预测

The application of peripheral serum interleukin-6 levels in predicting the recurrence of early hepatocellular carcinoma after receiving microwave ablation

目的探讨血清中白细胞介素-6(IL-6)和IL-22对早期乙型病毒性肝炎相关肝细胞癌患者(HBV-HCC)微波消融(MWA)治疗后复发的预测作用。方法收集49例经MWA治疗早期HBVHCC患者术前外周血,应用ELISA检测外周血IL-6与IL-22的含量,同期30例健康人作对照。据x-tile软件计算cut-off值将IL-6和IL-22水平分为高水平组和低水平组,Kaplan-Meier分析两组的无瘤生存期,Log rank检验差异性,Cox回归筛选影响HBV-HCC复发的危险因素。结果 HCC组的IL-6与IL-22水平明显高于对照组(IL-6:13.20(11.87~15.79)pg/ml和10.47(9.50~13.82)pg/ml,P=0.001;IL-22:42.18(34.39~57.44)pg/ml和25.45(22.31~30.12)pg/ml,P<0.001)。Kaplan-Meier分析显示HCC患者术前低IL-6、高总胆红素和低白蛋白水平预示较短无瘤生存期,IL-22对HCC复发的影响差异无统计学意义。Cox回归多因素分析显示低IL-6(≤13.2 pg/ml,HR:3.721,95%CI:1.674~8.272,P=0.001)与低白蛋白水平(≤41.0 g/L,HR:2.085,95%CI:1.101~3.950,P=0.024)是影响肝癌复发的独立危险因素。结论术前IL-6和白蛋白水平可作为MWA治疗HBV-HCC患者预测复发的指标。

Objective To investigate the clinical application of serum intedeukin- 6 （IL- 6）and interleukin-22 （IL-22） levels in predicting the recurrence of hepatitis B virus （HBV）-related early hepatocellular carcinoma （HCC） after receiving microwave ablation （MWA）. Methods Preoperative peripheral blood samples were collected in 49 patients with early-stage HBV-related HCC, and serum concentrations of IL-6 and IL-22 were measured by using ELISA. Thirty healthy volunteers were recruited and used as the control group.The x- tile software was used to define the best cut-off value, and the IL-6 and IL-22 levels were divided into high- level group and low-level group. The tumor-free survivals of high-level and low-level groups were analyzed with Kaplan-Meier analysis, log rank test was adopted to determine the difference, and Cox regression model was employed to screen the risk factors affecting HBV-related HCC recurrence. Results The serum IL- 6 and IL-22 levels of HCC group were 13.20 pg/ml （11.87-15.79 pg/ml） and 42.18 pg/ml （34.39-57.44 pg/ml） respectively, which were significantly higher than 10.47 pg/ml （9.50-13.82 pg/ml） and 25.45 pg/ml （22.31- 30.12 pg/ml） of the control group （P=0.001 and P〈0.001 respectively）. Kaplan-Meier analysis revealed that preoperative lower IL- 6, higher total bilirubin and lower albumin levels indicated a shorter disease- free survival （DFS）, and IL- 22 levels had no statistically significant effect on the recurrence of HCC. Cox regression multivariate analysis showed that lower serum IL-6 level （≤13.2 pg/ml; hazard ratio=3.721 ; 95%CI=1.674-8.272; P=0.001） and lower serum albumin level （≤41.0 g/L; hazard ratio=2.085; 95%CI=1.101- 3.950; P=0.024） were independent risk factors affecting HBV-related HCC recurrence. Conclusion Preoperative serum IL-6 level and serum albumin level can be used as the predictors of HCC recurrence in patients with HBV-related early HCC who are receiving MWA treatment.