Association of serum interleukin-17 level with early recurrence and prognosis after radical surgery in hepatocellular carcinoma patients with different levels of alpha-fetoprotein

Objective To investigate the expression of interleukin-17 (IL-17) in hepatitis B virus (HBV) -related hepatocellular carcinoma (HCC) with different levels of alpha-fetoprotein (AFP) , as well as its association with recurrence and prognosis after radical treatment for HCC.Methods A total of 167 patients with HBV-related HCC who underwent radical resection in The Affiliated Tumor Hospital of Xinjiang Medical University from January 2013 to December 2014 were enrolled, and 115 patients with hepatic hemangioma (including 83 HBV carriers) were enrolled as control group.ELISA was used to measure the serum level of IL-17 in 167 patients with HBV-related HCC, and electrochemical luminescence was used to measure the serum level of AFP.The correlation between the expression of IL-17 and the serum level of AFP was analyzed, as well as the association of the expression of IL-17 with recurrence and survival after radical resection of HCC.The chi-square test was used for comparison of categorical data between groups, and the Kaplan-Meier method, log-rank test, and Cox proportional hazards model were used for survival analysis.Results The patients with HBV-related HCC were divided into two groups according to the serum level of AFP, and there was a significant difference in the positive expression rate of IL-17 between AFP <400 ng/ml group and AFP≥400 ng/ml group [50.9% (58/114) vs 34.0% (18/53) , χ2= 8.11, P = 0.002]; there were also significant differences between these two groups in disease-free survival (34.1 months vs 13.4 months, χ2= 10.34, P < 0.05) , overall survival (84.2 months vs 57.4 months, χ2= 3.13, P < 0.05) , and tumor recurrence rate within 1 year (28.9% vs 50.9%, χ2= 10.89, P <0.05) .The Kaplan-Meier analysis showed that among the patients with HBV-related HCC and AFP < 400 ng/ml, the patients with positive expression of IL-17 had a significantly higher recurrence rate within 1 year after surgery than those with negative expression of IL-17, as well as significantly shorter disease-free survival and overall survival than those with low expression of IL-17 (χ2= 7.350, 3.814, and9.744, all P < 0.05) .The Cox proportional hazards model showed that positive expression of IL-17, tumor thrombus in vessels, and degree of tumor differentiation were influencing factors for the prognosis of HCC patients (all P < 0.05) .Conclusion For patients with HBV-related HCC and AFP < 400 ng/ml, positive expression of IL-17 indicates early recurrence and poor prognosis.