Complex interaction networks of cytokines after transarterial chemotherapy in patients with hepatocellular carcinoma

Abstract

Inflammation in the tumor microenvironment influences all stages of HCC development and progression as well as the anti-cancer response by immune system. In this study, we studied cytokine networks before and after transarterial chemotherapy (TACE). Serum samples obtained from 203 HCC patients treated with TACE were analyzed for inflammatory cytokines including interleukin (IL)-1{beta}, IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-12, IL-13, IL-17, IL-22, TNF-, IFN-{gamma}, and C-reactive protein (CRP) levels. Cytokine concentrations were measured at day 0 (D0, baseline), day3 (D3), day7 (D7), and day 60 (D60) after TACE. Network analysis revealed that modules within cytokine network at D0 were lost by D60 and modularity value (Mc) was decreased from 0.177 at D0 to -0.091 at D60. D60 had the lowest network heterogeneity and lower diameter, clustering coefficient, network density and recruited nodes. Degree correlation revealed that assortative network turned to disassortative network by D60 indicating that the network gained scale free feature. CRP, IL-2 were components of modules related with adverse outcome and IL-13, favorable outcome. Median survival month of patient group with high and low values with P-values were as follows: D0 CRP, 9.5 month (M), 54.2M (P<0.0001); D0 IL-2, 39.9M, 56.1M (P=0.0084); D3 CRP, 31.3M, 55.1 M (P=0.0056); D7 CRP, 28.7M, 50.7M (P=0.0065); IL-13, 51.9M, 33.6M (P=0.06). Network modularity decreased with temporal changes. Components of modules that included CRP, IL-2 and IL-6 were associated with adverse outcome and short overall survival. These modules were dissolved by D60 after TACE. Degree correlation decreased by D60, indicating that the cytokine network gained the scale free network property as in other biological network. TACE treatment converted cytokine network from that with inflammatory module to that with scale free network feature and without modules. Further studies are required to verify temporal changes of cytokine network in HCC patients after TACE.