Balance between interleukin-10 and interleukin-12 in adult cancer patientswith or without infections

Reliable markers for identifying infections in cancer patients on admission are lacking. The utility of the balance between interleukin (IL)-10 and IL -12 was analysed in this respect. The infection group (n = 56) had higher m edian serum levels of IL-10 (3.8 pg/ml; interquartile range (IQR) 1.7-11.4 pg/ml versus 1.8 pg/ml; IQR 0.6-4.6 pg/ml; P=0.005) and IL-10 to IL-12 rati o (0.4; IQR 0.06-4.23pg/ml versus 0.05; IQR 0.02-0.31pg/ml; P < 0.001) than the non-infection group tit = 36). IL-10 and the ratio had the following f igures of sensitivity (79%; 95% confidence interval (CI) 66-88 versus 39%; 95% CI 27-53), specificity (40%, 95% CI 12-74 versus 90%; 95% CI 56-100) an d positive predictive value (88%; 95% CI 76-96 versus 96%; 95% CI 78-100) f or identifying infections (56 cases with infection and 10 with neoplastic f ever), and the corresponding area under curve (AUC) values for IL-IO and th e ratio in identifying infections in general were 0.58; 95% CT 0.39-0.78 ve rsus 0.64; 95% CI 0.46-0.82 and in bacteraemia 0.71; 95% CT 0.50-0.92 versu s 0.75; 95% CI 0.58-0.93, respectively. Thus, IL-10 can be used as a screen ing method for identifying infections in cancer patients and the ratio of I L-10 to IL-12 for confirming the diagnosis. (C) 2001 Elsevier Science Ltd. All rights reserved.