Prognostic Significance of Inflammatory Markers IL-6, sP-Selectin, TNF-α, BNP-32, and Procalcitonin Levels in Thoracic Surgery

Following surgical trauma, alterations of the immune response increased synthesis of proinflammatory cytokines, and lymphocytic proliferation occurs together with increased production of acute-phase reactants. We aimed to identify associations of such parameters regarding complications following major thoracic surgical interventions. Fifty-four cases aged over 18 years, who were planned to undergo surgery for lung cancer (34 cases) or causes other than lung cancer (20 cases), were included. Blood samples were collected preoperatively and postoperatively in the first and sixth hours, and on the first, fourth, and seventh days. Pleural fluid samples were obtained postoperatively in the first hour and on the first and fourth days. High trend of TNF-α both in serum and pleural fluid during the early postoperative period and low trend of serum sP-Selectin were associated with incomplete expansion. Regarding atelectasis, most consistent trends belonged to IL-6 and TNF-α pleural fluid measurements, both being high. High trend of serum BNP-32 involving preoperative and early postoperative periods and high trend of IL-6 in the pleural fluid were associated with postoperative pneumonia. Regression analysis revealed significant associations of PCT with all complications. TNF-α was associated with atelectasis and empyema, and IL-6 with postoperative fever. Our study provided results both consistent and inconsistent with the literature. BNP-32 was not indicative of atrial fibrillation. Among inflammatory markers, serum PCT and TNF-α values obtained in the preoperative or early postoperative period might serve as predictors for thoracic surgical complications.