Balance of proinflammatory and antiinflammatory cytokines at thoracic cancer operation

Background. A homeostatic balance of proinflammatory and antiinflammatory cytokines is thought to be important for the maintenance of health. Cytokine baseline levels and response patterns to cardiac and nonmalignant abdominal operations have been investigated. The purpose of this study was to investigate the cytokine patterns at operation for thoracic cancer; the hypothesis tested was that cytokine baseline levels and response patterns would be unique for patients with malignant disease undergoing thoracic operation. Methods. Ten patients undergoing pulmonary 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: baseline tumor necrosis factor-alpha (39.1 pg/mL) and interleukin-10 (76.76 pg/mL) were elevated without significant changes. Interleukin-l receptor antagonist became elevated postoperatively (871.6 pg/mL) compared with baseline (332.8 pg/mL) (p < 0.01). The level of tumor necrosis factor soluble receptor-2 was elevated at baseline (4,823.3 pg/mL) and remained elevated postoperatively (7,293.4 pg/mL) (p < 0.01). Conclusions. Our hypothesis was supported; a separate pattern of proinflammatory and antiinflammatory cytokine levels and responses to thoracic operation 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 Surgeons.