Assessment of interleukin-6 in diagnosis of hepatocellular carcinoma

ABSTRACT

Interleukin-6 [IL-6] is a promising tumor marker for hepatocellular carcinoma [HCC]. IL-6 may help to identify a subset of HCC patients with low alpha-fetoprotein [AFP] level and may serve as a complementary tumor marker. To assess the value of serum interleukin-6 levels in patients with chronic liver disease and its level in patients with HCC. To evaluate as well its sensitivity and specificity in comparison to AFP in diagnosis of HCC. Seventy five patients with chronic liver disease [the population of the study] were assessed for serum interleukin-6 levels. The patients were allocated into three groups Group I Included 25 patients diagnosed as chronic liver disease with no evidence of HCC. Group II Included 25 patients diagnosed as HCC on top of post-viral hepatitic chronic liver disease with elevation in AFP [>200ng]. Group III Included 25 patients diagnosed as HCC on top of post-viral hepatitis chronic liver disease without elevation in AFP [200ng]. Control group Included 25 age- and sex-matched healthy volunteer controls, with no evidence of liver disease and/or of neoplasm. This study revealed a high statistically significant difference between the three studied groups and controls regarding serum IL-6 levels [P<0.01]. There was a statistical significant positive correlation between mean levels of I L-6 and AFP in HCC patients in group II and III [HCC= 50cases] [P< 0.05]. Regarding the Child-Pugh staging of liver disease, the study revealed that the mean levels of IL-6 in Child C was higher than in Child A and B, but without a statistically significant difference. By using multiple logistic regressions, only loss of weight and AFP had a statistical significant association with the diagnosis of HCC in this study [P< 0.05]. The diagnostic value of IL-6 is significantly increased when it is associated with AFP measurement. Combining the two markers provides a new perspective in the diagnosis of HCC. Our data indicate that IL-6 may be a promising marker for assessment of chronic liver disease [according to Child-Pugh Staging System]. Unfortunately, Interleukin-6 is not a candidate novel tumor marker in detecting HCC patients [with serum AFP level below 200ng/ml]