Dysregulated Interleukin Expression in Iraqi Hepatocellular Carcinoma: Diagnostic and Prognostic Implications

Chronic inflammation associated with viral hepatitis and other environmental factors contributes to the development of liver diseases, including hepatocellular carcinoma, which represents an important health issue in Iraq. The aim of this study was to determine the expression levels of interleukin-6, interleukin-10, interleukin-17, and interleukin-23 in hepatocellular carcinoma patients and evaluate the clinical applicability of these genetic markers.

The study was designed as a case-control study including 242 patients with hepatocellular carcinoma and 288 age- and sex-matched healthy controls. We used qPCR and ELISA assays to determine the studied markers.

Each of the pro-inflammatory interleukins described showed significant dysregulation in patients with hepatocellular carcinoma. Relative to the controls, the gene expression of IL-6, IL-17, and IL-23 showed increases of 8.74-fold, 6.92-fold, and 7.38-fold**, respectively** (p < 0.001). There was a 69% decrease in the expression of IL-10 (p < 0.001). A similar trend was found in the serum concentrations compared with the expression of the studied genes. There were significant positive correlations between the inflammatory interleukins and the size of the tumour, the concentration of alpha-fetoprotein, and the stage of the disease. The integrated interleukin model demonstrated excellent diagnostic performance with an AUC of 0.943.

There were significant dysregulation of the inflammatory interleukins in Iraqi patients with hepatocellular carcinoma with substantial correlations to the severity of the disease. These findings demonstrate the potential use of inflammatory interleukins as diagnostic and prognostic markers and highlight the need for further research to validate therapeutic targets.