Predictive value of interleukin-27 and clinical pathological factors on local tumor progression after microwave ablation of liver cancer

Objective To investigate the predictive effect of interleukin-27clinical pathological factors on local tumor progression after microwave ablation of liver cancer. Methods Collection of blood samples from 102 patients with hepatic malignancies treated with microwave ablation from January 2014 to December 2016 in Department of General Surgery, Lianyungang Oriental Hospital of Xuzhou Medical University. There were 80 males and 22 females, aged 24 to 83 years old, mean (58.7±11.4) years old. Patient age, gender, hepatitis, tumor diameter, tumor number, tumor boundary, tumor type, tumor blood perfusion degree, liver Child-Pugh classification, whether liver cirrhosis and peripheral blood IL-27 concentration and tumor local progression relationship were analyzed.Detection of IL-27 concentration in peripheral blood using ELISA.The Youden index was calculated using the receiver operating characteristic curve (ROC) to obtain the best cutoff value for IL-27 levels.Patients were divided into 61 patients with high IL-27 (>498.45 pg/L) and 41 patients with low IL-27 (≤ 498.45 pg/L) with optimal cut-off value.Measurement data were expressed as mean ± standard deviation (Mean±SD), and comparison between groups was evaluated by t test; Comparison of count data was evaluated by chi-square test. Survival curves were plotted by Kaplan-Meier method and survival rates were calculated; Cox proportional hazard regression model was used for multivariate analysis. Results The total incidence of local tumor progression was 35.3% (36/102). The IL-27 value of 102 patients ranged from(34.92-1 014.87) pg/L.The ROC curve of IL-27 value was plotted based on 2-year tumor-free survival as the endpoint. The area under the curve was AUC of 0.714 (P=0.017). When the IL-27 value was 498.45 pg/L, the Youden index was the largest, the sensitivity was 0.682, and the specificity was 0.556.The 2-year disease-free survival rate of all patients was 64.2%.The 2-year disease-free survival rates of patients with high IL-27 and low IL-27 were 72.7% and 50.5%, respectively. Survival analysis by Kaplan-Meier method showed that the prognosis of patients with high IL-27 group was better than that of patients with low IL-27 group (χ2=5.991, P=0.014). Univariate analysis of tumor local progression was associated with tumor >3 cm (χ2=7.170, P=0.007), tumor adjacent to large vessels (χ2=9.301, P=0.002), and high degree of tumor perfusion (χ2=5.599, P=0.018), IL-27 high level (χ2=5.460, P=0.019). Cox proportional hazard model analysis of tumor>3 cm, tumor adjacent to large blood vessels, low IL-27 level was an independent risk factor for tumor progression. Conclusions The level of IL-27, tumor ≥3 cm and tumor adjacent large blood vessels are predictor of local tumor progression after microwave ablation of liver cancer. Patients with low IL-27 levels have a high rate of local tumor progression. Key words: Liver neoplasms; Neoplasm recurrence, local; Disease-free survival; Interleukin-27; Forecasting; Microwave ablation