白细胞介素-6 水平对预测肝移植前肝细胞癌组织病理学特征的附加价值。

Additional value of interleukin-6 level to predict histopathological features of hepatocellular carcinoma before liver transplantation.

机构信息

Service de Chirurgie Hépatique et Pancréatique, Chirurgie Générale et Transplantation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67200 Strasbourg, France; University of Strasbourg, 4 Rue Kirschleger, 67000 Strasbourg, France.

出版信息

Cytokine. 2023 Sep;169:156286. doi: 10.1016/j.cyto.2023.156286. Epub 2023 Jun 27.

DOI:10.1016/j.cyto.2023.156286

PMID:37385083

Abstract

BACKGROUND & AIMS: Inflammatory biomarkers are increasingly used as outcome predictors in the field of oncology and liver transplantation for HCC, but no study has shown the prognostic value of IL6 after LT. The goal of this study was to evaluate the predictive value of IL-6 on histopathological features of HCC on explant, its predictive value on recurrence risk and its additional value to other scores and inflammatory markers at the time of transplantation.

METHODS

From 2009 to 2019, all adults transplanted with a first liver graft and diagnosed with HCC on the explant analysis were retrospectively included (n = 229). Only patients who had a pre-LT IL6 level determination were analysed in this study (n = 204).

RESULTS

High IL-6 level at transplantation was associated with a significantly higher risk of vascular invasion (15% vs 6%; p = 0.023), microsatellitosis (11% vs 3%; p = 0.013), lower rate of histological response both in terms of complete response (2% vs 14%, p = 0.004) and of necrosis (p = 0.010). Patients with pre-LT IL-6 level > 15 ng/ml had a lower overall and cancer-specific survival (p = 0.013). Recurrence-free survival was lower in patients with IL-6 > 15 ng/ml with a 3-year recurrence-free survival of 88% versus 78% (p = 0.034). IL6 levels were significantly higher in patients with early recurrence compared to patients without (p = 0.002) or with late recurrence (p = 0.044).

CONCLUSIONS

IL6 level at transplantation is an independent predictor of pejorative histological features of HCC and is associated to the risk of recurrence.

摘要

背景与目的

炎症生物标志物在肿瘤学和肝癌肝移植领域中越来越多地被用作预后预测指标，但尚无研究表明 IL6 在 LT 后对 HCC 的预后价值。本研究旨在评估 IL-6 在移植时对 HCC 组织学特征、复发风险的预测价值及其对其他评分和炎症标志物的附加价值。

方法

回顾性纳入 2009 年至 2019 年间接受首次肝移植且在肝移植标本分析中诊断为 HCC 的所有成年人（n=229）。本研究仅分析了术前有 IL6 水平测定的患者（n=204）。

结果

移植时高 IL-6 水平与血管侵犯（15%比 6%；p=0.023）、微卫星不稳定性（11%比 3%；p=0.013）显著相关，组织学反应率较低，完全反应（2%比 14%，p=0.004）和坏死（p=0.010）。术前 IL-6 水平>15ng/ml 的患者总生存率和无癌生存率较低（p=0.013）。IL-6>15ng/ml 的患者无复发生存率较低，3 年无复发生存率为 88%比 78%（p=0.034）。与无复发或迟发性复发的患者相比，早期复发的患者 IL6 水平明显更高（p=0.002）。