ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Bronchial cytokine level changes in lung cancer operations
Nilgün Kanlıoğlu Kuman1, Ertan Yaman2, Aslıhan Karul3, Salih Çokpınar1, Serdar Şen1, Ekrem Şentürk1
Department of Thoracic Surgery, Medical Faculty of Adnan Menderes University, Aydın, Turkey
1Departments of Thoracic Surgery, Medical Faculty of Adnan Menderes University, Aydın, Turkey
2Department of Thoracic Surgery, Çorum State Hospital, Çorum, Turkey
3Departments of Biochemistry, Medical Faculty of Adnan Menderes University, Aydın, Turkey
DOI : 10.5606/tgkdc.dergisi.2014.8335
Background: This study aims to evaluate effects of lung resection type, lymphovascular invasion and type of cancer on bronchial cytokine levels [interleukin (IL)-6, IL-8 and tumor necrosis factoralpha (TNF-a)].

Methods: Twenty-eight patients (27 males, 1 female; mean age 65.9±7.6 years; range 48 to 79 years) with lung cancer undergoing lung resection between August 2010 and December 2011 were enrolled in the study. None had fever, empyema or signs of lower respiratory tract infection. Bronchial lavage samples were collected from both sides of main bronchial systems right before the operation and from the operated bronchus right after the operation.

Results: No significant difference was observed between preoperative bronchial cytokines of both bronchial sites (with and without tumor). Tumor-side bronchial IL-6 and TNF-a were significantly increased after the operation compared to preoperative levels (p=0.001, p=0.045). Compared to lobectomy, IL-6 levels of the patients who underwent pneumonectomy were significantly higher (p=0.004). Significant difference was observed between preoperative contralateral bronchial IL-8 levels of patients in whom decortication was performed as an additional operational procedure and those underwent an isolated lung resection (p=0.017). There was a positive correlation between stage, stage subgroup, and preoperative contralateral bronchial IL-6 levels (p=0.005, p=0.027). Postoperative IL-6 levels were found to be higher in patients with lymphovascular invasion (p=0.008).

Conclusion: Bronchial cytokines, IL-6 and TNF-a levels, were markers of surgical injury on the tumor side from bronchial system following operation. As the tumor stage increases, the entire lungs are affected and the inflammatory response is expanded to contralateral hemithorax. Postoperative IL-6 levels may be an indicator of lymphovascular invasion. The extensiveness of the operation also affects the inflammatory response; IL-6 levels of the patients undergoing pneumonectomy may have significantly higher than lobectomy. Thus, it shows a relationship between IL-6 synthesis and the degree of surgical injury.

Keywords : Bronchial cytokines; lung cancer; lymphovascular invasion; resection
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