BALANCE OF PROINFLAMMATORY AND ANTIINFLAMMATORY CYTOKINES AT THORACICCANCER OPERATION

Background. A homeostatic balance of proinflammatory and antiinflammat ory cytokines is thought to be important for the maintenance of health . Cytokine baseline levels and response patterns to cardiac and nonmal ignant abdominal operations have been investigated. The purpose of thi s study was to investigate the cytokine patterns at operation for thor acic cancer; the hypothesis tested was that cytokine baseline levels a nd response patterns would be unique for patients with malignant disea se undergoing thoracic operation. Methods. Ten patients undergoing pul monary tumor resections were studied. Blood samples were collected at six perioperative time points. Results. The cytokine response of these patients differed from patients undergoing cardiac operations: baseli ne tumor necrosis factor-alpha (39.1 pg/mL) and interleukin-10 (76.76 pg/mL) were elevated without significant changes. Interleukin-l recept or antagonist became elevated postoperatively (871.6 pg/mL) compared w ith baseline (332.8 pg/mL) (p < 0.01). The level of tumor necrosis fac tor soluble receptor-2 was elevated at baseline (4,823.3 pg/mL) and re mained elevated postoperatively (7,293.4 pg/mL) (p < 0.01). Conclusion s. Our hypothesis was supported; a separate pattern of proinflammatory and antiinflammatory cytokine levels and responses to thoracic operat ion was determined. This pattern may be indicative of tumor burden or detrimental to tumor surveillance; it merits further evaluation. (Ann Thorac Surg 1998;66;1145-50) (C) 1998 by The Society of Thoracic Surge ons.