background: the aim of this study was to determine the potential prognostic roles of the perioperative interleukin-6 (il-6) level and its dynamic changes in patients with hepatocellular carcinoma (hcc) undergoing transarterial chemoembolization (tace).
materials and methods: sixty patients with hepatitis b virus-associated hcc receiving tace were enrolled in the study. serum il-6 levels were determined at baseline and 1 day after tace by immunoassay. response to tace was evaluated after a 4-6-week interval. factors associated with tumor response were analyzed by univariate and multivariate analysis in a cox regression model. receiver operating characteristic (roc) curve analysis was performed to assess the predictive performance of the included variables on tumor response in patients with hcc undergoing tace.
results: the serum il-6 level was significantly elevated 1 day after tace. patients in the low postintervention il-6 level group had a high probability of achieving an objective response (or) (66.7% vs. 18.8%, p = .021). post-tace il-6 level (≤12.7 pg/ml) and post-/pre-tace neutrophils ratio (>2.47) were independently correlated with or after tace. roc curve analysis showed that a combined index based on those two factors exhibited optimal predictive power of tumor response among all the included variables (area under the curve = 0.740, 95% confidence interval: 0.601-0.879). additionally, high post-tace plasma il-6 level was associated with maximum tumor size, vascular invasion, post-tace aspartate aminotransferase, and barcelona clinic liver cancer stage.
结果：tace术后1天血清il-6水平明显升高。干预后il-6水平较低的患者达到客观缓解(or)的几率较高(66.7% vs. 18.8%， p = .021)。tace术后il-6水平(≤12.7 pg/ml) 、tace术后/术前中性粒细胞比率(>2.47)与tace术后or独立相关。roc曲线分析显示，在纳入的所有变量中(曲线下面积= 0.740,95%ci:0.601-0.879)，基于这两个因素的综合指数对肿瘤反应的预测力最佳。此外，tace术后血浆il-6高水平与最大肿瘤体积、血管侵犯、tace术后天冬氨酸转氨酶和巴塞罗那临床肝癌分期相关。
conclusion: our study suggests that the post-treatment serum il-6 level, rather than pretreatment or dynamic changes of il-6, serves as a powerful predictor for tumor response. these findings provide evidence to help discriminate between patients who will particularly benefit from tace and those who require more personalized therapeutic regimens and rigorous surveillance.