Responses of cytokines and coagulation-fibrinolytic states to surgical stress following esophagectomy.
OBJECTIVE
Surgery for esophageal cancer is one of the most invasive treatments in gastrointestinal surgery. The aim of this study was to analyze perioperative kinetics of coagulation-fibrinolytic states in comparison with cytokines in order to investigate biological responses to surgical stress in patients undergoing esophagectomy.


METHODS
Serum or plasma samples of 20 patients with esophageal cancer who had undergone esophagectomy were collected during the perioperative period. Serial concentrations of cytokines (IL-6, IL-8, IL-10), PMN-E, and coagulation-fibrinolytic agents (TAT and PIC) were measured and analyzed.


RESULTS
There were significant increases in concentrations of both inflammatory and anti-inflammatory cytokines during the operative and postoperative courses. TAT and PIC levels also increased significantly intra- and postoperatively. The TAT/PIC ratio was elevated simultaneously with a predominance of inflammatory cytokines over anti-inflammatory ones.


CONCLUSIONS
In addition to the profile of cytokines, the TAT/PIC ratio seems to be a sensitive and useful indicator in evaluating biological responses to surgical stress.
Kobayashi
Makoto
M
Department of Surgery I, Faculty of Medicine, Tottori University, Yonago, Japan. makoto_k@h8.dion.ne.jp
Tsujitani
Shunichi
S
Kurisu
Yasuro
Y
Kaibara
Nobuaki
N
D000368:Aged; D000933:Antifibrinolytic Agents / Q000097:blood; D000990:Antithrombin III; D016207:Cytokines / Q000097:blood*; D004938:Esophageal Neoplasms / Q000276:immunology / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007432:Intraoperative Period; D007564:Japan; D019272:Leukocyte Elastase / Q000097:blood; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000097:blood; D011183:Postoperative Complications / Q000276:immunology*; D011184:Postoperative Period; D012016:Reference Values; D013312:Stress, Physiological / Q000150:complications* / Q000276:immunology
D000933:Antifibrinolytic Agents; D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; C046193:antithrombin III-protease complex; D016753:Interleukin-10; D000990:Antithrombin III; D010447:Peptide Hydrolases; D019272:Leukocyte Elastase