Annals of Oncology Advance Access originally published online on October 24, 2007
Annals of Oncology 2008 19(2):353-358; doi:10.1093/annonc/mdm448
gastrointestinal tumors |
Circulating interleukin-6 as a tumor marker for hepatocellular carcinoma
,*
1 Internal Medicine and Medical Oncology
2 Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo University Hospital Foundation, Pavia
3 Department of Computer Science and Systems, University of Pavia, Pavia
4 Department of Biochemistry, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo University Hospital Foundation, Pavia, Italy
* Correspondence to: Dr C. Porta, Internal Medicine and Medical Oncology, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo University Hospital Foundation, Piazzale C. Golgi, 19, I-27100 Pavia, Italy. Tel: +39-0382-501355; Fax: +39-0382-526223; E-mail: c.porta{at}smatteo.pv.it
Background: A large amount of evidence suggests a possible role of interleukin-6 (IL-6) in the pathogenesis of hepatocellular carcinoma (HCC).
Patients and methods: We studied both IL-6 and A1FP in patients with HCC, non-neoplastic liver disease or in healthy controls.
Results: IL-6 titers were four-fold higher in cancer than in cirrhotic patients and 25-fold higher than in healthy controls. As for alpha1-fetoprotein (A1FP) titers, the highest levels were observed in cancer patients. Receiver operating characteristic (ROC) curves analysis demonstrated that IL-6 is significantly more discriminant than A1FP, with ‘optimal’ cut-off values of 7.9 pg/ml (sensitivity = 0.83, specificity = 0.83, efficiency = 0.83). The ROC curves used to distinguish HCC from cirrhotic patients only, showed higher discriminant power of IL-6 versus A1FP titers, with a new cut-off value of 12 pg/ml (sensitivity = 0.73, specificity = 0.87, efficiency = 0.8). Discriminant analysis on HCC and non-HCC subjects yielded sensitivity, specificity and efficiency rates of 77%, 93% and 88%, respectively. The overall efficiency of the two tests combined was 82%.
Conclusions: IL-6 could be considered a promising tumor marker for HCC. In particular, the diagnostic value of the test is significantly increased when combined with A1FP.
Key words: A1FP, cirrhosis, HCC, IL-6, tumor markers
These authors equally contributed to this work. Received for publication May 21, 2007. Revision received August 9, 2007. Accepted for publication August 13, 2007.
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