Background: Interleukin-6 (IL-6) is used as a marker for infection and inflammation. After liver surgery, IL-6 is also crucial for hepatic regeneration. The value of IL-6 serum-levels to differentiate infection from imminent post-hepatectomy liver failure (PHLF) remains unclear. This review focuses on IL-6 and complications after liver resections, specifically PHLF and infections. Methods: A systematic review was performed in the PubMed, Embase, and Cochrane libraries from January 2000 to June 2025 according to PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). All English language human data publications were assessed. Results: Overall, 12 studies (n= 589 patients) evaluating perioperative serum IL-6 levels were included. Six publications reported PHLF rates, and two specifically addressed IL-6, PHLF, and infection. Several patient and surgical parameters influence IL-6 dynamics. Despite five randomized trials being published, the overall study quality was low, with a high risk of bias. In particular, IL-6 on the first postoperative day was associated with PHLF and infections, but multivariable analyses of confounding factors are lacking. A meta-analysis of studies with a specific cut-off calculation was precluded by heterogeneous cohorts and endpoints. Conclusions: IL-6 levels may have early diagnostic value regarding imminent infectious complications or PHLF early after liver resection, but the evidence is exploratory and limited by methodological weaknesses. At present, IL-6 as a single marker does not seem to show sufficient clinical discriminatory potential to differentiate between infection and impaired hepatic regeneration. Future studies should address confounding factors, ideal timepoints of assessment, different methods of serum IL-6 assays, specific cut-offs, and multi-marker combinations.
背景：白细胞介素-6（IL-6）是感染与炎症的常用标志物。在肝脏手术后，IL-6对肝再生亦具有关键作用。目前，血清IL-6水平在鉴别感染与即将发生的肝切除术后肝衰竭（PHLF）方面的价值尚不明确。本综述聚焦于IL-6与肝切除术后并发症（特别是PHLF和感染）的关系。 方法：根据PRISMA指南（系统综述与荟萃分析优先报告条目），于2000年1月至2025年6月期间对PubMed、Embase和Cochrane数据库进行系统性文献检索。所有英文人类数据研究均被纳入评估。 结果：共纳入12项研究（涉及589例患者），评估围手术期血清IL-6水平。其中6篇文献报告了PHLF发生率，2篇专门探讨IL-6、PHLF与感染的关联。多项患者及手术参数会影响IL-6的动态变化。尽管已有5项随机试验发表，但整体研究质量较低，存在较高的偏倚风险。特别值得注意的是，术后第一天的IL-6水平与PHLF及感染相关，但尚缺乏对混杂因素的多变量分析。由于研究队列和终点的异质性，无法对设定具体截断值的研究进行荟萃分析。 结论：IL-6水平可能在肝切除术后早期对即将发生的感染并发症或PHLF具有诊断价值，但现有证据仅为探索性，且受限于研究方法学的不足。目前，IL-6作为单一标志物尚不足以在临床上有效区分感染与肝再生障碍。未来研究应关注混杂因素、最佳检测时间点、不同血清IL-6检测方法、特异性截断值以及多标志物联合检测策略。
肿瘤(癌症)患者之家