High-level Expression of Interleukin-17 and C-reactive Protein Predicts Tumor Progression in Unresectable Hepatocellular Carcinoma Treated by Transarterial Chemoembolization |
Myeong Jun Song1, Sung Won Lee2, Eun-Jee Oh3, Bohyun Jang4, Jeong Won Jang4, Si Hyun Bae4, Jong Young Choi4, Seung Kew Yoon4 |
1Division of Hepatology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon 2Division of Hepatology, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon 3Department of Laboratory Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 4Divsion of Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea |
Correspondence:
Si Hyun Bae, Email: baesh@catholic.ac.kr |
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Abstract |
Background/Aims Transarterial chemoembolization (TACE) is the standard locoregional
treatment in patients with unresectable hepatocellular carcinoma (HCC). Angiogenesis and
inflammation play important roles in tumor growth in HCC. In this study, we evaluated the
associations between the levels of growth factors and inflammatory markers and clinical
prognosis in patients with unresectable HCC treated with TACE. Methods The clinical outcomes of 58 HCC patients treated with TACE at the Catholic Medical
Centers from January, 2012 to February 2015 were evaluated. Baseline levels of the growth
factors vascular endothelial growth factor, fibroblast growth factor, platelet-derived growth
factor, and hepatocyte growth factor and the inflammatory cytokines interleukin (IL)-17 and
high sensitivity C-reactive protein (hs-CRP) were compared with the treatment outcomes. The
primary endpoint was time to progression (TTP); the secondary endpoint was overall survival
(OS). Results During the 20.8 months of follow-up, TTP was significantly delayed in patients with
low levels of hs-CRP (≤0.15) and IL-17 (≤0.94) and a maximal tumor diameter ≤5 cm (P =0.010,
P =0.015, and 0.048, respectively). Patients with HCC with low hs-CRP and IL-17 levels had
a longer survival than that of those with high hs-CRP levels and IL-17 (35.1 vs. 22.5 months,
P =0.000; 41 vs. 21.8 months, P =0.000, respectively). However, any baseline growth factors
were not significantly correlated with TTP and OS. Conclusions Elevated IL-17 and hs-CRP may be predictive of a poor outcome in patients
with HCC treated with TACE. A better understanding of this relationship will require further
investigation of the immune mechanisms underlying tumor progression. |
Key Words:
Chemoembolization; Growth factors; Cytokine; Progression; Survival |
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