title: Preoperative interleukin-6 production by mononuclear blood cells predicts survival after radical surgery for colorectal carcinoma.
abstract: BACKGROUND
  Colorectal cancer is one of the most common forms of cancer in the Western world. Staging based on histopathology is currently the most accurate predictor of outcome after surgery. Colorectal cancer is curable if treated at an early stage (stage I-III). However, for tumors in stages II and III there is a great need for tests giving more accurate prognostic information defining the patient population in need of closer follow-up and/or adjuvant therapy. Furthermore, tests that provide prognostic information preoperatively could provide a guide both for preoperative oncologic treatment and the surgical procedure.
  
  
  METHODS
  Peripheral blood mononuclear cells (PBMCs) were isolated preoperatively, within a week before primary surgery, from 39 patients undergoing surgery for colorectal cancer. The PBMCs were cultured in vitro for 24 hours in the presence of autologous serum and lipopolysaccharide (LPS). Interleukin-6 (IL-6) production was measured with enzyme-linked immunosorbent assay (ELISA). Staging based on histopathology was performed in all patients. Patients were followed for at least 54 months.
  
  
  RESULTS
  A production of >5000 pg/mL of IL-6 identified colorectal cancer patients with a poor prognosis. Eight out of 13 patients with >5000 pg/mL IL-6 died from cancer within the follow-up period, whereas no cancer-related deaths were recorded among 21 patients with 5000 pg/mL IL-6 or less. A multivariate Cox regression analysis, stratified for T- and N-stage, identified IL-6 production as an independent prognostic factor.
  
  
  CONCLUSIONS
  IL-6 production in vitro by PBMC can predict survival after radical surgery for colorectal cancer.
authors.affiliation: Division of Clinical Tumorimmunology and Department of Oncology, University Hospital of Linkoping, Linkoping, Sweden. Birgitta.Clinchy@lio.se
authors.forename: Birgitta
authors.initials: B
authors.lastname: Clinchy
authors.forename: Annelie
authors.initials: A
authors.lastname: Fransson
authors.forename: Bengt
authors.initials: B
authors.lastname: Druvefors
authors.forename: Anna
authors.initials: A
authors.lastname: Hellsten
authors.forename: Annika
authors.initials: A
authors.lastname: Håkansson
authors.forename: Bertil
authors.initials: B
authors.lastname: Gustafsson
authors.forename: Rune
authors.initials: R
authors.lastname: Sjödahl
authors.forename: Leif
authors.initials: L
authors.lastname: Håkansson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D015179:Colorectal Neoplasms / Q000097:blood* / Q000401:mortality* / Q000601:surgery*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D053208:Kaplan-Meier Estimate; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D015850:Interleukin-6