Bronchial cytokine level changes in lung cancer operations.

Amac: Bu calismada akciger rezeksiyon tipinin, lenfovaskuler invazyonun ve kanser turunun bronsiyal sitokin duzeyleri uzerine [interlokin (IL)-6, IL-8 ve tumor nekroz faktor-alfa (TNF-a)] etkileri degerlendirildi. Ca­lis­ma­pla­ni:­Agustos 2010 Aralik 2011 tarihleri arasinda akciger kanseri nedeniyle akciger rezeksiyonu uygulanan 28 hasta (27 erkek, 1 kadin; ort yas 65.9±7.6 yil; dagilim 48-79 yil) calismaya alindi. Hicbirinde ates, ampiyem veya alt solunum yolu enfeksiyonu bulgulari yoktu. Brons lavaji ornekleri hemen ameliyat oncesi ana brons sistemlerinin her iki tarafindan ve hemen ameliyat sonrasi ameliyat edilen ana bronstan toplandi. Bul gu lar: Ameliyat oncesi her iki bronsiyal bolgeden alinan brons sitokinleri arasinda (tumoru olan ve olmayan) anlamli farklilik gozlenmedi. Tumor tarafi bronsiyal IL-6 ve TNF-a duzeyleri ameliyat oncesi duzeyler (p=0.001, p=0.045) ile karsilastirildiginda, ameliyat sonrasi anlamli olcude artmisti. Pnomonektomi uygulanan hastalarda IL-6 duzeyleri lobektomiye kiyasla yuksek bulundu (p=0.004). Ilave bir cerrahi islem olarak dekortikasyon yapilan hastalar ile izole sadece akciger rezeksiyonu uygulanan hastalarin ameliyat oncesi kontralateral bronsiyal IL-8 duzeyleri arasinda anlamli farklilik gozlendi (p=0.017). Evre, evre alt grubu ile ameliyat oncesi kontralateral bronsiyal IL-6 duzeyi (p=0.005, p=0.027) arasinda pozitif iliski vardi. Ameliyat sonrasi IL-6 duzeyleri lenfovaskuler invazyon saptanan (p=0.008) hastalarda daha yuksek bulundu. So­nuc:­Ameliyat sonrasi bronsiyal sistem tumor tarafi bronsiyal sitokin IL-6 ve TNF-a duzeyleri cerrahi travmanin bir gostergesi olabilir. Tumor evresi arttikca, tum akciger etkilenir ve enflamatuvar yanit kontralateral hemitoraksa kadar yayilir. Ameliyat sonrasi IL-6 duzeyleri lenfovaskuler invazyonun bir gostergesi olabilir. Ameliyatin buyuklugune gore enflamatuvar yanit etkilenmektedir; pnomonektomi uygulanan hastalarin IL-6 duzeyleri lobektomilere kiyasla anlamli duzeyde yuksek seyredebilir. Bu sonuc, IL-6 sentezi ve cerrahi travma derecesi arasindaki iliskiyi gostermektedir. Anah tar soz cuk ler: Bronsiyal sitokinler; akciger kanseri; lenfovaskuler invazyon; rezeksiyon. 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.