Soluble interleukin-2 receptor levels in hepatocellular cancer: A more sensitive marker than alfa fetoprotein

Francesco Izzo, Francesco Cremona, Paolo Delrio, Enrico Leonardi, Giuseppe Castello, Sandro Pignata, Bruno Daniele, Steven A. Curley

Research output: Contribution to journalArticle

Abstract

Background: Worldwide, the majority of cases of hepatocellular cancer (HCC) arise in individuals with chronic hepatitis B or C virus infections. Early detection of HCC in these patients provides the best chance for curative treatment, but serum alfa fetoprotein (AFP) levels are frequently normal in patients with small HCCs. The purpose of this study was to determine: (1) whether soluble interleukin-2 receptor (sIL-2R) levels are elevated more frequently than AFP levels in HCC patients and (2) whether sIL- 2R levels are useful as a marker of successful treatment and recurrence of disease. Patients and Methods: We are performing a prospective screening program with high-risk, chronic hepatitis virus-infected patients to detect HCC. Patients are screened by using abdominal ultrasonography, serum AFP measurements, and serum sIL-2R measurements. Normal serum slL-2R levels were established using results from 174 healthy volunteers with no evidence of hepatitis virus infection or HCC. Results: HCC has been diagnosed in 99 patients from a cohort of 1520 screened patients. Serum AFP levels were elevated in 79 patients (80%), whereas sIL-2R levels were elevated in 98 of the 99 patients (99%, P <.01, χ2 test). For 27 of the 99 patients (27%), HCC was diagnosed at an early stage and complete resection or ablation was performed. Serum sIL-2R levels returned to normal in all 27 patients after treatment, whereas AFP levels remained slightly elevated in 5 of the 27 (18%). Among the 16 patients in this group of 27 who developed recurrent HCC, sIL-2R levels became elevated in all 16, whereas AFP levels were elevated at diagnosis of recurrence for only 10 (P <.05). Conclusions: This study with chronic hepatitis B or C virus-infected patients indicates that (1) serum sIL-2R levels are abnormal in patients with HCC with a significantly greater frequency, compared with AFP levels, and (2) sIL-2R levels are a more sensitive marker of successful treatment and recurrence of HCC. Based on these findings, we now use serum sIL-2R measurements both to screen high- risk patients and to monitor treatment responses in patients with hepatitis who develop HCC.

Original languageEnglish
Pages (from-to)178-185
Number of pages8
JournalAnnals of Surgical Oncology
Volume6
Issue number2
Publication statusPublished - 1999

Keywords

  • Hepatitis virus
  • Hepatocellular cancer
  • Interleukin-2 receptor

ASJC Scopus subject areas

  • Surgery
  • Oncology

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