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ORIGINAL ARTICLE
Year : 2014  |  Volume : 10  |  Issue : 8  |  Page : 304-306

Plasma interleukin 17 in the diagnosis of hepatocellular carcinoma: A retrospective study of 39 cases


Department of Clinical Laboratory, The 2nd People's Hospital of Tianjin, Tianjin 300192, China

Date of Web Publication17-Feb-2015

Correspondence Address:
Jianyong Liu
Department of Clinical Laboratory, The 2nd People's Hospital of Tianjin, Tianjin 300192
China
Wei Lu
Department of Clinical Laboratory, The 2nd People's Hospital of Tianjin, Tianjin 300192
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.151537

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 > Abstract 

Objective: The purpose of this retrospective study was to evaluate the diagnosis efficacy of plasma interleukin 17 (IL-17) for hepatocellular carcinoma (HCC).
Materials and Methods: Thirty-nine patients with confirmed HCC and 41 healthy controls were retrospectively analyzed in this study. The serum level of IL-17 was tested by enzyme-linked immunosorbent assay. And the plasma level of carcino-embryonic antigen (CEA) and alpha fetoprotein (AFP) were arrayed by radioimmunoassay. The plasma level of IL-17, CEA and AFP between HCC and healthy control group were compared. And the diagnostic sensitivity and specificity for IL-17, CEA and AFP in patients with HCC was calculated using the GraphPad Prism 5.0 software.
Results: The plasma level of IL-17, CEA and AFP were 2.88 ± 1.75 (ng/L), 2.99 ± 2.12 (μg/L) and 6.91 ± 4.56 (mg/L) in healthy control group and 5.57 ± 1.59 (ng/L), 8.31 ± 5.40 (μg/L) and 190.50 ± 79.08 (mg/L) in HCC group. Plasma level of IL-17, CEA and AFP in HCC group was statistical higher than in healthy control group (all P < 0.05). For plasma IL-17, the diagnostic sensitivity and specificity were 74.36% and 75.61% at the cut-off value of 4.23 (ng/L) with the area under the receiver operating characteristic (ROC) curve of 0.86; For plasma CEA, the diagnostic sensitivity and specificity were 69.23% and 70.73% at the cut-off value of 4.14 (μg/L) with the area under the ROC curve of 0.80; For plasma AFP, he diagnostic sensitivity and specificity were 100.00% and 65.85% at the cut-off value of 10.25 (mg/L) with the area under the ROC curve of 0.96.
Conclusion: Plasma IL-17 was significant elevated in patients with HCC compared to healthy control group which could be a potential biomarker for diagnosis of HCC.

Keywords: Alpha fetoprotein, carcino-embryonic antigen, hepatocellular carcinoma, interleukin 17


How to cite this article:
Liu J, Zhou G, Lu W. Plasma interleukin 17 in the diagnosis of hepatocellular carcinoma: A retrospective study of 39 cases. J Can Res Ther 2014;10, Suppl S4:304-6

How to cite this URL:
Liu J, Zhou G, Lu W. Plasma interleukin 17 in the diagnosis of hepatocellular carcinoma: A retrospective study of 39 cases. J Can Res Ther [serial online] 2014 [cited 2020 Oct 24];10:304-6. Available from: https://www.cancerjournal.net/text.asp?2014/10/8/304/151537


 > Introduction Top


With the high prevalence of hepatitis B virus (HBV) infection in China, [1] the hepatocellular carcinoma (HCC) screening is necessary which could identify the presence of the early or potential HCC in an asymptomatic individual. [2] The most used serum biomarker for HCC screening or diagnosis was alpha fetoprotein (AFP). Data coming from China showed that in an screening for HCC patients with HBV or with chronic hepatitis with the positive predictive value of 3.3%. [3] This indicated that AFP was a useful tool for HCC screening. But some studies reported that the serum AFP frequently not elevated in early stage HCC and its utility as a biomarker was limited. [4]

Interleukin 17 (IL-17), originally identified as a transcript from a rodent T-cell hybridoma by in 1993. Recently, some study showed that the serum IL-17 was elevated in HCC patients. So, we perform this retrospectively to further evaluate the clinical value of IL-17 for diagnosis of HCC. [5]


 > Materials and methods Top


Patients selection

Thirty-nine patients with pathology or cytology confirmed HCC and 41 healthy controls were retrospectively analyzed in this study. The inclusion criteria for HCC group were: (1) Patients were confirmed by pathology/cytology or imaging; (2) first diagnosis without any treatment; (3) with complete information such as age, tumor nodes metastasis stage, and plasma IL-17, carcino-embryonic antigen (CEA) and AFP. The general characteristic of included HCC and healthy control were demonstrated in [Table 1].
Table 1: The detailed characteristic of the two groups

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Measurement of plasma interleukin-17 carcino-embryonic antigen and alpha fetoprotein

Interleukin-17 levels in serum were determined using enzyme-linked immunosorbent assay kits according to the manufacturers' instructions. The plasma level of CEA and AFP were measured by radioimmunoassay according to the manufacturers' instructions.

Statistical analysis

STATA-10.0 (http://www.stata.com; Stata Corporation, College Station, TX) and GraphPad Prism 5.0 statistical (http://www.graphpad.com/scientific-software/prism) software were used to deal with the data. Comparisons between the HCC and healthy control group were made using Student's t-test. The performance characteristics for the diagnosis of HCC were obtained using receiver operating characteristic (ROC) curves. The sensitivity and specificity of these three markers for the diagnosis of HCC were calculated at the cut-off value. The ROC curves analysis was performed for area under the curve values for the plasma IL-17, CEA, and AFP. All P values were two-tailed with P < 0.05 considered as statistically significance.


 > Results Top


Plasma level of interleukin-17 carcino-embryonic antigen and alpha fetoprotein

The plasma level of IL-17, CEA and AFP were 2.88 ± 1.75 (ng/L), 2.99 ± 2.12 (μg/L) and 6.91 ± 4.56 (mg/L) in healthy control group and 5.57 ± 1.59 (ng/L), 8.31 ± 5.40 (μg/L) and 190.50 ± 79.08 (mg/L) in HCC group. Plasma level of IL-17, CEA and AFP in HCC group was statistical higher than in healthy control group (all P < 0.05) [Figure 1].
Figure 1: The distribution of interleukin-17 in hepatocellular carcinoma and healthy controls

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The diagnostic value of plasma interleukin-17 carcino-embryonic antigen and alpha fetoprotein

For plasma IL-17, the diagnostic sensitivity and specificity were 74.36% and 75.61% at the cut-off value of 4.23 (ng/L) with the area under the ROC curve of 0.86; for plasma CEA, the diagnostic sensitivity and specificity were 69.23% and 70.73% at the cut-off value of 4.14 (μg/L) with the area under the ROC curve of 0.80; for plasma AFP, he diagnostic sensitivity and specificity were 100.00% and 65.85% at the cut-off value of 10.25 (mg/L) with the area under the ROC curve of 0.96 [Figure 2].
Figure 2: Receiver operating characteristic curves of total interleukin-17, carcino-embryonic antigen and alpha fetoprotein for diagnosis of hepatocellular carcinoma

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 > Discussion Top


It has been reported that an estimated 26,190 cases were diagnosed in the United States in the year of 2011 with approximately 19,590 death at the same year. [6] HCC is the fifth most diagnosed cancer and the third leading cause of death from cancer in the world. [7] Its 5 years natural mortality rate more than 95%, and it affects more than 500,000 people in the world a year, more than 50% of whom are in China. [8] Chronic infection with HBV remains the dominant risk factor in China, where the prevalence of hepatitis B is more than 10%. [1] Other risk factors include infection with hepatitis C virus, exposure to aflatoxins, excessive alcohol consumption, and tobacco smoking. [9],[10],[11]

In this study, we found that the plasma level of IL-17, CEA and AFP were significant elevated in HCC patients compared with healthy control group. This indicated that the plasma IL-17, CEA, and AFP could be potential biomarkers for HCC diagnosis. Thus, we further evaluated the value plasma IL-17, CEA, and AFP separately for diagnosis of HCC. We found that for plasma IL-17, the diagnostic sensitivity and specificity were 74.36% and 75.61% at the cut-off value of 4.23 (ng/L) with the area under the ROC curve of 0.86; For plasma CEA, the diagnostic sensitivity and specificity were 69.23% and 70.73% at the cut-off value of 4.14 (μg/L) with the area under the ROC curve of 0.80; for plasma AFP, the diagnostic sensitivity and specificity were 100.00% and 65.85% at the cut-off value of 10.25 (mg/L) with the area under the ROC curve of 0.96. We found that the diagnosis efficacy of AFP was higher than IL-17 and CEA.

Inclusion, plasma IL-17 was significant elevated in patients with HCC compared to healthy control group which could be a potential biomarker for diagnosis of HCC. But the diagnosis sensitivity and specificity for IL-17 were relative low that limited its useful for HCC biomarker. And several limitations such as a small number of HCC and healthy control included, retrospectively study design and single heal care center data made the evidence weak. So, prospective diagnostic studies were need for further evaluated the diagnosis value of plasma IL-17 as a biomarker in screening or diagnosis of HCC.

 
 > References Top

1.
Liang X, Bi S, Yang W, Wang L, Cui G, Cui F, et al. Epidemiological serosurvey of hepatitis B in China - declining HBV prevalence due to hepatitis B vaccination. Vaccine 2009;27:6550-7.  Back to cited text no. 1
    
2.
Song P, Feng X, Zhang K, Song T, Ma K, Kokudo N, et al. Screening for and surveillance of high-risk patients with HBV-related chronic liver disease: Promoting the early detection of hepatocellular carcinoma in China. Biosci Trends 2013;7:1-6.  Back to cited text no. 2
    
3.
El-Serag HB, Marrero JA, Rudolph L, Reddy KR. Diagnosis and treatment of hepatocellular carcinoma. Gastroenterology 2008;134:1752-63.  Back to cited text no. 3
    
4.
Tangkijvanich P, Anukulkarnkusol N, Suwangool P, Lertmaharit S, Hanvivatvong O, Kullavanijaya P, et al. Clinical characteristics and prognosis of hepatocellular carcinoma: Analysis based on serum alpha-fetoprotein levels. J Clin Gastroenterol 2000;31:302-8.  Back to cited text no. 4
    
5.
Sha-Sha F, Ai-min LI, Rong LI, Feng-sheng C, Jun-yi Z, Rong-cheng L. IL-17 expression increased as a diagnostic marker in the serum of hepatocellular carcinoma patients. J Nat Sci Hunan Norm Univ 2014;37:19-23.  Back to cited text no. 5
    
6.
DeSantis C, Naishadham D, Jemal A. Cancer statistics for African Americans, 2013. CA Cancer J Clin 2013;63:151-66.  Back to cited text no. 6
    
7.
Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin 2014;64:9-29.  Back to cited text no. 7
    
8.
Liang X, Bi S, Yang W, Wang L, Cui G, Cui F, et al. Reprint of: Epidemiological serosurvey of Hepatitis B in China - declining HBV prevalence due to Hepatitis B vaccination. Vaccine 2013;31 Suppl 9:J21-8.  Back to cited text no. 8
    
9.
Hammad LN, Abdelraouf SM, Hassanein FS, Mohamed WA, Schaalan MF. Circulating IL-6, IL-17 and vitamin D in hepatocellular carcinoma: Potential biomarkers for a more favorable prognosis? J Immunotoxicol 2013;10:380-6.  Back to cited text no. 9
    
10.
Tomiyama Y, Takenaka K, Kodama T, Kawanaka M, Sasaki K, Nishina S, et al. Risk factors for survival and the development of hepatocellular carcinoma in patients with primary biliary cirrhosis. Intern Med 2013;52:1553-9.  Back to cited text no. 10
    
11.
Fares N, Péron JM. Epidemiology, natural history, and risk factors of hepatocellular carcinoma. Rev Prat 2013;63:216-7, 20-2.  Back to cited text no. 11
    


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