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Eur J Cardiothorac Surg 2007;31:719-724. doi:10.1016/j.ejcts.2007.01.027
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Interleukin 6 and interleukin 1 receptor antagonist as early markers of complications after lung cancer surgery

^a Department of Thoracic Surgery, Regional Lung Diseases Hospital, 82-550 Prabuty, Kuracyjna Street 30, Poland
^b Department of Surgical Research and Transplantology, Medical Research Center, Polish Academy of Sciences, Warsaw, Poland
^c Olsztyn City Hospital, Olsztyn, Poland
^d Department of Human Nutrition, Medical University of Warsaw, Poland
^e Department of General, Gastroenterologic Surgery and Nutrition, Medical University of Warsaw, Poland

Received 8 September 2006; received in revised form 23 December 2006; accepted 15 January 2007.

^_* Corresponding author. Tel.: +48 55 2326377; fax: +48 55 2782435. (Email: szczesny{at}lungcancer.med.pl).

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.

Key Words: Lung cancer • Surgery • Complications • IL-6 • IL-1ra

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