Predictive value of changes of IL-6, IL-18, AFP levels in peripheral blood of patients with primary liver cancer on pulmonary infection

Abstract

Abstract: Objective To explore the predictive value of peripheral serum levels of interleukin-6 (IL-6), serum interleukin-18 (IL-18), and alpha fetoprotein (AFP) for pulmonary infection in patients with primary liver cancer. Methods 118 patients with primary liver cancer admitted to our hospital from January 2019 to December 2022 were included as the study subjects. All patients received hepatic artery chemoembolization treatment, and the incidence of pulmonary infection after treatment was recorded and divided into an infected group and an uninfected group. Clinical data and peripheral blood levels of IL-6, IL-18, and AFP were collected and compared between the two groups of patients upon admission. The predictive value of these three peripheral blood indicators for pulmonary infection in patients with primary liver cancer was analyzed. Results Out of 118 patients with primary liver cancer, 26 cases (22.03%) developed pulmonary infection. The proportion of patients with a history of liver cancer rupture in the infected group was higher than that in the uninfected group (46.15% vs. 21.74%), and the difference was statistically significant (P<0.05); The peripheral blood IL-6 [(70.54 ± 21.49) pg/mL], IL-18 [(136.52 ± 20.79) mg/L], and AFP [(35.04 ± 5.32) ng/mL] in the infected group were higher than those in the uninfected group [(47.76 ± 16.31) pg/mL, (94.89 ± 12.16) mg/L, (15.69 ± 4.24) ng/mL], and the difference was statistically significant (P<0.05). The results of logistic regression analysis showed that peripheral blood levels of IL-6, IL-18, AFP, and a history of liver cancer rupture were risk factors for pulmonary infection in patients with primary liver cancer (OR=1.054, 1.021, 45.241, 3.086, P<0.05). The receiver operating characteristic (ROC) curves showed that the area under the curve (AUC) of peripheral blood IL-6, IL-18, AFP, and their combined prediction of pulmonary infection in patients with primary liver cancer were 0.738, 0.782, 0.705, and 0.785, respectively. Conclusion The sreum levels of IL-6, IL-18, and AFP are risk factors for pulmonary infection in patients with primary liver cancer, and have certain value in predicting pulmonary infection.

Key words: Primary liver cancer, Pulmonary infection, Interleukin-6, C-reactive protein, Procalcitonin

NIU Xing-jie, LIU Zhi-hui, CUI Feng-mei, ZHANG Guo-min, LIU Yao-min. Predictive value of changes of IL-6, IL-18, AFP levels in peripheral blood of patients with primary liver cancer on pulmonary infection[J]. Chinese Hepatolgy, 2025, 30(4): 471-475.

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