title: Interleukin 6 and interleukin 1 receptor antagonist as early markers of complications after lung cancer surgery.
abstract: 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.
authors.affiliation: Department of Thoracic Surgery, Regional Lung Diseases Hospital, 82-550 Prabuty, Kuracyjna Street 30, Poland. szczesny@lungcancer.med.pl
authors.forename: Tomasz Jaroslaw
authors.initials: TJ
authors.lastname: Szczesny
authors.forename: Robert
authors.initials: R
authors.lastname: Slotwinski
authors.forename: Aleksander
authors.initials: A
authors.lastname: Stankiewicz
authors.forename: Bruno
authors.initials: B
authors.lastname: Szczygiel
authors.forename: Marzanna
authors.initials: M
authors.lastname: Zaleska
authors.forename: Maria
authors.initials: M
authors.lastname: Kopacz
mesh_terms: 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
chemical_list: D015415:Biomarkers; D053590:Interleukin 1 Receptor Antagonist Protein; D015850:Interleukin-6