Abstract
PURPOSE: To examine the clinical significance of circulating lymphocyte subtypes and cytokines in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). PATIENTS AND METHODS: We enrolled 53 patients and assessed lymphocyte subsets (CD4+ T cells, CD8+ T cells, CD4+/CD8+ cell ratio, natural killer cells, and regulatory T cells) and cytokines (interleukin [IL]-2, IL-4, IL-6, IL-10, and interferon [IFN]-γ) on the day before TACE, and 1 day and 4-8 weeks thereafter. The correlation between baseline inflammatory markers and IL-6, the differences between clinical subgroups, and the prognostic baseline inflammatory values and changes therein were analyzed. RESULTS: We found that baseline IL-6 was positively correlated with IL-10 and IFN-γ. Univariate analysis revealed that patients with higher baseline IL-6, IL-10, and IFN-γ levels had worse liver function and greater tumor burden, suggesting a poor prognosis. Multivariate analysis showed that higher baseline IFN-γ levels were associated with a shorter time to tumor progression (hazard ratio [HR] = 1.912; 95% confidence interval [CI] = 1.013-3.607; p = 0.045), and higher IL-10 levels were associated with poor overall survival (HR = 2.576; 95% CI = 1.237-5.364; p = 0.011). Baseline lymphocyte subtypes and changes therein did not have any significant association with prognosis. CONCLUSION: This study confirmed the association between inflammation and poor prognosis. The prognostic significance of IFN-γ was different from previous studies, while the prognostic significance of lymphocyte subtypes remains to be verified.