Preoperative and postoperative cytokines in patients with cancer

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Abstract
Background. Changes in tumor necrosis factor-alpha (TNF-α), interleukin-1 alpha (IL-1α), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and granulocyte macrophage-colony-stimulating factor (GM-CSF) were investigated before and after operation in patients with hepatocellular carcinoma (HCC), metastatic liver carcinoma, and gastrointestinal carcinoma. Results. Serum levels of TNF-α, IL-1α, and IL-1β were high in patients with liver carcinoma (HCC and metastatic liver carcinoma) before operation in comparison with those of normal controls (P < 0.01). In patients with gastrointestinal carcinoma, serum levels of cytokines, except those of TNF-a, were the same as in patients with liver carcinoma. The level of TNF-α in patients with gastrointestinal carcinoma was low compared with that in patients with liver carcinoma. Within 1 day after operation, the peak level of TNF-a was observed at 15 hours, IL-1α at 18 hours, IL-1β at 21 hours, and IL-6 at 24 hours after operation. Subsequently, these cytokine levels peaked again: TNF-α at 48 hours, IL-1α at 72 hours, IL-1β at 120 hours, and IL-6 at 168 hours after operation. GM-CSF levels increased gradually after operation. Moreover, in HCC, serum levels of TNF-α were high in patients with recurrence compared with those without recurrence (P < 0.01). The difference in IL-1α and IL-1β levels between patients with recurrence and those without recurrence can be regarded as significant (P < 0.01). Conclusion. These results suggest that TNF-α, IL-1, IL-6, and GM-CSF may play an important role in the pathogenesis of cancers; TNF-α may be especially important as a tumor marker in HCC and metastatic liver carcinoma. Cancer 1992; 70:709–713.

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