Abstract: Objective The purpose of this study was to explore the predictive efficacy of serum interleukin-33 (IL-33) and procalcitonin (PCT) levels for bacterial infection in primary liver cancer (PLC) patients with fever after transcatheter arterial chemoembolization (TACE). Methods A total of 150 patients with PLC were enrolled in our hospital between April 2020 and April 2022, and all patients underwent TACE. The bacterial infection was diagnosed based on blood routine, serology, imaging and bacterial characterization. Serum IL-33 level was detected by ELISA. The receiver operating characteristic (ROC) curves were drawn by SPSS statistical software and the diagnostic performance was analyzed by the area under the ROC curve (AUC). Results Out of the 150 patients with PLC, the bacterial infection was diagnosed in 50 cases(33.3%) after TACE; the incidence of diabetes, tumor in TNM Ⅲ stage, the diameters of tumor greater than 5 cm and the multiple tumors in patients with bacterial infection were much higher than in patients without (P<0.05); serum PCT and IL-33 levels in patients with bacterial infection were (14.91±3.23) ng/mL and (42.2±8.5)pg/mL, significantly higher than [(0.06±0.01)pg/mL and (13.4±4.9)pg/mL, respectively, P<0.05] in patients without; the AUCs were 0.869(95%CI=0.804-0.898, P<0.001), 0.786(95%CI=0.712-0.849, P<0.001) and 0.895(95%CI=0.855-0.912, P<0.001) when serum PCT, IL-33 levels and combination of the two parameters were applied to predict bacterial infection in PLC patients with fever after TACE, suggesting the combination superior to serum PCT or IL-33 alone (Z=1.784, P=0.074) as the combination having the sensitivity of 0.770 and the specificity of 0.930. Conclusion The increased serum IL-33 and PCT levels might hint the bacterial infection in PLC patients with fever after TACE, and warrants further clinical investigation.

Key words: Hepatoma, Transcatheter arterial chemoembolization, Bacterial infection, Interleukin-33, Procalcitonin, Diagnosis