Plasma interleukin-17 and alpha-fetoprotein combination effectively predicts imminent hepatocellular carcinoma occurrence in liver cirrhotic patients

Abstract

Background Predicting imminent hepatocellular carcinoma (HCC) in liver cirrhotic patients is an unmet medical need. We aimed to investigate circulatory biomarkers and their optimum combinations in a prospective study. Methods We investigated plasma interleukin 17 (IL-17) concentrations, quantified using enzyme-linked immunosorbent assay (ELISA), for the prediction of HCC in a large cohort of 404 HCC-naïve liver cirrhotic patients regularly followed after recruitment. Additionally, IL-17 in surgically resected tumor tissues were evaluated using immunohistochemistry staining. Results IL-17 was detected in HCC tissues. The IL-17 concentrations in the peripheral blood do not have correlation with an extensive list of 31 common demographic, metabolic and liver function variables in the cohort of liver cirrhotic patients. Furthermore, patients stratified by IL-17 and alpha-fetoprotein (AFP) showed distinctive cumulative incidence of HCC. Imminent HCC, defined here as HCC occurrence within 1 year, can be predicted by IL-17 alone with an area under the receiver operating characteristic curve [AUC] of 0.762 (P = 0.002). An multivariate analysis showed that age, hepatitis C viral infection, AFP and IL-17 were four independent factors associated with imminent HCC (adjusted P = 0.03, 0.041, 0.024 and 0.008 respectively). An explicit risk score (R) combining the concentrations of two plasma biomarkers, AFP and IL-17, achieved a high AUC of 0.933 (95% confidence interval 0.893–0.972, P < 0.001) in predicting imminent HCC, with 100% sensitivity and 79.9% specificity at the optimum cutoff. The score is defined as: $${\text{R}} = (2.6914)*{\text{IL-17}} + (0.3909)*{\text{AFP}} - (0.80812875)*{\text{IL-17}}^{2} + (0.10288876884)*{\text{IL-17}}^{2} *{\text{AFP}}.$$ R = ( 2.6914 ) ∗ IL-17 + ( 0.3909 ) ∗ AFP - ( 0.80812875 ) ∗ IL-17 2 + ( 0.10288876884 ) ∗ IL-17 2 ∗ AFP . Conclusions The circulatory IL-17 concentration is a predictor of subsequent HCC occurrence in liver cirrhotic patients. The combination of AFP and IL-17 is highly effective in predicting imminent HCC within 1 year.

Serum total IgE as immunological marker in patients with chronic hepatitis B Virus infection, and hepatitis B related hepatocellular carcinoma

“…The results of current study showed that there were significant correlations between the level of IgE and transaminases (ALT, AST) and between IgE and AFP in both study groups (group I and group II), which agreed with some previous studies 23,34 . However, these were in contradictory to findings of other studies 25,33 , who reported negative association between IgE and transaminases.…”

Early changes in peripheral blood cytokine levels after the treatment of metastatic hepatic carcinoma with CalliSpheres microspheres drug-eluting beads transcatheter arterial chemoembolization

“…Circulating blood IL-17 concentration is also considered to be a predictive factor of hepatocellular carcinoma (HCC) in patients with liver cirrhosis. The combination of alpha-fetoprotein (AFP) and IL-17 has a high sensitivity for predicting HCC within 1 year (13). In the NASH-HCC model, the inflammatory factor FGF21 can inhibit liver cells-TLR4-IL-17-A signaling pathway to prevent the conversion of NASH to HCC (14).…”

Oncogenic Roles of Polycomb Repressive Complex 2 in Bladder Cancer and Upper Tract Urothelial Carcinoma

“…Gene signature risk models were derived using the generalized iterative modeling approach, a type of machine learning approach which performs empirical maximization with respect to either the log likelihood in the proportional hazards model [ 30 ] or the area under the receiver operating characteristic curve in classification analysis [ 31 ]. In this study, we selected to maximize the log likelihood in the time-to-MIBC survival analysis.…”