[Responses of cytokines, acute phase proteins, and polymorphonuclear cell elastase to surgical stress in the patients with esophageal cancer].

The serum levels of cytokines (interleukin-1 beta; IL-1 beta, interleukin-6; IL-6, tumor necrosis factor alpha; TNF alpha), and acute phase proteins (CRP, alpha 1-antitrypsin; alpha 1-AT, alpha 1-acid glycoprotein; alpha 1-AG, fibrinogen; FBG, pancreatic secretory trypsin inhibitor; PSTI), and the plasma concentration of polymorphonuclear cell elastase; PMN-E and white blood cell counts were measured in 18 patients with esophageal cancer who underwent radical esophagectomy through right thoracotomy and reconstruction with gastric tube. Peripheral venous blood samples were obtained before and just after operation, and on the 1st, 2nd, 3rd, 7th and 14th post-operative day. The serum concentrations of IL-6 just after operation were significantly correlated with volume of blood loss during operation and duration of thoracotomy. Plasma PMN-E levels just after operation seemed to be correlated with those factors, but its correlation was not statistically significant. Serum IL-6 levels began to increase markedly just after operation, and reached the maximum by the 1st post-operative day. This elevation preceded that of acute phase proteins, indicating that IL-6 may induce the production of acute phase proteins in vivo. Furthermore, peak serum values of IL-6 after operation were correlated with volume of blood loss and duration of thoracotomy. These results suggest that elevation of IL-6 and PMN-E levels may reflect the degree of surgical stress, and the measurement of IL-6 and PMN-E is useful for the early detection of an inflammatory response.