Gastrointestinal Cancer Symposium: Original Article
Prognostic role of serum interleukin‑18 in Egyptian patients with hepatitis c virus-related hepatocellular carcinoma treated by radiofrequency ablation Mohran Z, Abdelkader NA, Abdelmoez AT, Abolmaaty ME1, Abbas AA2, Abdelfattah M Departments of Tropical Medicine, 1Diagnostic Radiology, and 2Clinical Pathology, Ain Shams University, Cairo, Egypt Correspondence to: Dr. Amal Tohamy Abdelmoez, E‑mail: [email protected]
Abstract AIM: The aim of this study is to identify the prognostic value of serum interleukin (IL)‑18 level in hepatitis C virus (HCV) -related hepatocellular carcinoma (HCC) patients. MATERIALS AND METHODS: This study was conducted in Tropical Medicine department and HCC unit in Ain Shams University Hospitals. It included 35 patients with HCV associated HCC fit for radio frequency ablation and 20 healthy control subjects. Serum IL‑18 level was measured for all participants at the beginning of the study. Patients were followed‑up for 1 year then serum IL‑18 re‑measured at the end of the follow‑up period. RESULTS: Pre‑intervention serum IL‑18 level was significantly higher in patients than healthy control subjects and was associated with bad clinical, laboratory or radiological prognosis. Post follow‑up mean value of IL‑18 level was significantly lower than pre‑intervention level. CONCLUSION: Higher pre‑intervention serum IL‑18 level in HCV -related HCC patients level was associated with bad prognosis either clinically, laboratory or radiologically. Key Words: Hepatocellular carcinoma, interleukin-18, radiofrequency ablation.
Introduction Hepatocellular carcinoma (HCC) is the fifth most common cancer in men world‑wide.[1] In Egypt, HCC was reported 4.7% of chronic liver disease patients.[2] National cancer registry reported that HCC is one of the most common three cancers in Egypt.[3] The association between immune cells and cancer has been known for some time.[4] Interleukin (IL)‑18 is a cytokine known to be produced by cells including macrophages, dendritic cells, etc.[5] Originally described as an interferon‑gamma‑inducing factor, [6] promoting Th1 responses in synergy with IL‑12.[7] IL‑18 was shown to be slightly higher in the HCC tumor tissue versus the normal surrounding tissue.[8] Serum IL‑18 level may have prognostic significance in some types of cancer, including colonic carcinoma, gastric carcinoma, esophageal carcinoma.[9‑13] Asakawa et al. (2006)[14] reported that IL‑18 receptor was expressed in HCC tissues and two cell lines. Serum IL‑18 levels in patients with HCC correlated with advanced stage, presence of venous invasion.[15] This study aims to evaluate the prognostic value of IL‑18 in patients with hepatitis C virus (HCV) related HCC when measured before intervention and after 1 year of follow‑up. Materials and Methods This prospective study was conducted at tropical medicine department and HCC unit in Ain Shams University hospitals in the period from January 2010 to December 2010. A total of 35 patients with HCV associated HCC and 20 control healthy subjects were included in this study. Access this article online Quick Response Code:
Website: www.indianjcancer.com DOI: 10.4103/0019-509X.146739 PMID: *****
342
Patients were diagnosed by: Abdominal triphasic computed tomography (CT) criteria suggestive of HCC (intense arterial enhancement and wash out in venous and delayed phases) ± alpha fetoprotein (AFP) >200 ng/ml and/or liver biopsy and histopathological examination when indicated. Ethical considerations
The objectives of the study were explained to all patients who met the pre‑designed inclusion criteria and they were asked to sign a written informed consent form. Approval of ethical committee of Faculty of Medicine, Ain Shams University was obtained. Inclusion criteria
Patients with HCV associated HCC and candidates for radiofrequency ablation (RFA) management. All patients were subjected to: (1) Complete clinical evaluation. (2) Full investigations including: (i) Complete blood count, liver profile, renal functions and alpha fetoprotein and serum IL‑18 (before intervention). (ii) Abdominal ultrasound and triphasic CT scan. (iii) RFA. The patients were followed for 1 year after RFA then serum IL‑18 was reassessed. Exclusion criteria
Any other etiology of liver disease apart from HCV, vascular invasion, extra hepatic spread, any other co‑morbid condition e.g. renal failure, heart failure, or cerebrovascular stroke or patients not fit or refusing intervention. Statistical analysis
Descriptive statistics: (1) Quantitative data: Mean standard deviation (±SD). (2) Qualitative data: Frequency and percentage. Analytical statistics: (1) Quantitative data: Student’s t‑test. (2) Qualitative data: Chi‑square test. (3) Logistic regression. Levels of significance: (1) P
Prognostic role of serum interleukin‑18 in Egyptian patients with hepatitis c virus-related hepatocellular carcinoma treated by radiofrequency ablation Mohran Z, Abdelkader NA, Abdelmoez AT, Abolmaaty ME1, Abbas AA2, Abdelfattah M Departments of Tropical Medicine, 1Diagnostic Radiology, and 2Clinical Pathology, Ain Shams University, Cairo, Egypt Correspondence to: Dr. Amal Tohamy Abdelmoez, E‑mail: [email protected]
Abstract AIM: The aim of this study is to identify the prognostic value of serum interleukin (IL)‑18 level in hepatitis C virus (HCV) -related hepatocellular carcinoma (HCC) patients. MATERIALS AND METHODS: This study was conducted in Tropical Medicine department and HCC unit in Ain Shams University Hospitals. It included 35 patients with HCV associated HCC fit for radio frequency ablation and 20 healthy control subjects. Serum IL‑18 level was measured for all participants at the beginning of the study. Patients were followed‑up for 1 year then serum IL‑18 re‑measured at the end of the follow‑up period. RESULTS: Pre‑intervention serum IL‑18 level was significantly higher in patients than healthy control subjects and was associated with bad clinical, laboratory or radiological prognosis. Post follow‑up mean value of IL‑18 level was significantly lower than pre‑intervention level. CONCLUSION: Higher pre‑intervention serum IL‑18 level in HCV -related HCC patients level was associated with bad prognosis either clinically, laboratory or radiologically. Key Words: Hepatocellular carcinoma, interleukin-18, radiofrequency ablation.
Introduction Hepatocellular carcinoma (HCC) is the fifth most common cancer in men world‑wide.[1] In Egypt, HCC was reported 4.7% of chronic liver disease patients.[2] National cancer registry reported that HCC is one of the most common three cancers in Egypt.[3] The association between immune cells and cancer has been known for some time.[4] Interleukin (IL)‑18 is a cytokine known to be produced by cells including macrophages, dendritic cells, etc.[5] Originally described as an interferon‑gamma‑inducing factor, [6] promoting Th1 responses in synergy with IL‑12.[7] IL‑18 was shown to be slightly higher in the HCC tumor tissue versus the normal surrounding tissue.[8] Serum IL‑18 level may have prognostic significance in some types of cancer, including colonic carcinoma, gastric carcinoma, esophageal carcinoma.[9‑13] Asakawa et al. (2006)[14] reported that IL‑18 receptor was expressed in HCC tissues and two cell lines. Serum IL‑18 levels in patients with HCC correlated with advanced stage, presence of venous invasion.[15] This study aims to evaluate the prognostic value of IL‑18 in patients with hepatitis C virus (HCV) related HCC when measured before intervention and after 1 year of follow‑up. Materials and Methods This prospective study was conducted at tropical medicine department and HCC unit in Ain Shams University hospitals in the period from January 2010 to December 2010. A total of 35 patients with HCV associated HCC and 20 control healthy subjects were included in this study. Access this article online Quick Response Code:
Website: www.indianjcancer.com DOI: 10.4103/0019-509X.146739 PMID: *****
342
Patients were diagnosed by: Abdominal triphasic computed tomography (CT) criteria suggestive of HCC (intense arterial enhancement and wash out in venous and delayed phases) ± alpha fetoprotein (AFP) >200 ng/ml and/or liver biopsy and histopathological examination when indicated. Ethical considerations
The objectives of the study were explained to all patients who met the pre‑designed inclusion criteria and they were asked to sign a written informed consent form. Approval of ethical committee of Faculty of Medicine, Ain Shams University was obtained. Inclusion criteria
Patients with HCV associated HCC and candidates for radiofrequency ablation (RFA) management. All patients were subjected to: (1) Complete clinical evaluation. (2) Full investigations including: (i) Complete blood count, liver profile, renal functions and alpha fetoprotein and serum IL‑18 (before intervention). (ii) Abdominal ultrasound and triphasic CT scan. (iii) RFA. The patients were followed for 1 year after RFA then serum IL‑18 was reassessed. Exclusion criteria
Any other etiology of liver disease apart from HCV, vascular invasion, extra hepatic spread, any other co‑morbid condition e.g. renal failure, heart failure, or cerebrovascular stroke or patients not fit or refusing intervention. Statistical analysis
Descriptive statistics: (1) Quantitative data: Mean standard deviation (±SD). (2) Qualitative data: Frequency and percentage. Analytical statistics: (1) Quantitative data: Student’s t‑test. (2) Qualitative data: Chi‑square test. (3) Logistic regression. Levels of significance: (1) P
