Interleukin 6 and interleukin 1 receptor antagonist as early markers of complications after lung cancer surgery.
OBJECTIVE
To assess changes of interleukin 6 (IL-6) and interleukin 1 receptor antagonist (IL-1ra) in serum, sputum, and drained pleural fluid of patients operated on due to lung cancer.


METHODS
Twenty-seven patients treated with lobectomy or pneumonectomy, including 14 with complications and 13 without complications, were analyzed. Serum IL-6 and IL-1ra concentration was measured before, at the end of surgery, and on postoperative day 1, 3, and 7, by ELISA test. Additionally, concentration of IL-6 and IL-1ra was measured in sputum at the end of surgery and in pleural fluid on postoperative day 1.


RESULTS
In the entire group serum concentrations of IL-6 and IL-1ra were significantly elevated after surgery, in comparison with preoperative values. Serum IL-6 concentration was higher in patients with complications only on day 7 (median 59.0 (range: 41.25-76.65) pg/ml vs 21.5 (9.87-35.0) pg/ml; p=0.012). Patients with complications had higher concentration of IL-6 in pleural fluid (91312 (51812-94872) pg/ml vs 2006 (1926-2108) pg/ml; p=0.00008). Serum IL-1ra concentration was higher in patients with complications on day 1 (1832.4 (1144.7-2362.2) pg/ml vs 1088.4 (817.5-1312.5) pg/ml; p=0.01). Concentration of IL-1ra in drained fluid was higher in patients with complications (68128.8 (48104-108564) pg/ml vs 16470 (15930-16875) pg/ml; p=0.0003). On day 1 after surgery a significant correlation between serum and pleural fluid concentration for IL-6 as well as for IL-1ra were observed (Spearman test for IL-6: r=0.47; p=0.02; for IL-1ra: r=0.48; p=0.02).


CONCLUSIONS
Elevated concentrations of IL-6 and IL-1ra in pleural fluid on postoperative day 1 are promising early markers of postoperative complications. Elevated concentrations of IL-6 and IL-1ra in serum are good early markers of severity of surgical injury and may reflect development of postoperative complications.
Szczesny
Tomasz Jaroslaw
TJ
Department of Thoracic Surgery, Regional Lung Diseases Hospital, 82-550 Prabuty, Kuracyjna Street 30, Poland. szczesny@lungcancer.med.pl
Slotwinski
Robert
R
Stankiewicz
Aleksander
A
Szczygiel
Bruno
B
Zaleska
Marzanna
M
Kopacz
Maria
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D005260:Female; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000032:analysis* / Q000097:blood; D015850:Interleukin-6 / Q000032:analysis* / Q000097:blood; D008168:Lung / Q000601:surgery; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000737:chemistry; D011183:Postoperative Complications / Q000378:metabolism*; D011446:Prospective Studies; D013183:Sputum / Q000737:chemistry
D015415:Biomarkers; D053590:Interleukin 1 Receptor Antagonist Protein; D015850:Interleukin-6