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Serum concentrations of proinflammatory biomarker interleukin-6 (IL-6) as a predictor of postoperative complications after elective colorectal surgery

V. Procházka, L. Lacina, K. Smetana, M. Svoboda, K. Skřivanová, M. Beňovská, J. Jarkovský, L. Křen, Z. Kala

. 2023 ; 21 (1) : 384. [pub] 20231214

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc24000237

Grantová podpora
Conceptual development of research organisation, FNBr, 65269705 Ministerstvo Zdravotnictví Ceské Republiky,Czechia
Conceptual development of research organisation, FNBr, 65269705 Ministerstvo Zdravotnictví Ceské Republiky,Czechia
Conceptual development of research organisation, FNBr, 65269705 Ministerstvo Zdravotnictví Ceské Republiky,Czechia
Conceptual development of research organisation, FNBr, 65269705 Ministerstvo Zdravotnictví Ceské Republiky,Czechia
Conceptual development of research organisation, FNBr, 65269705 Ministerstvo Zdravotnictví Ceské Republiky,Czechia
project National Institute for Cancer Research (Programme EXCELES, ID Project No. LX22NPO5102) Operational Programme Research, Development, and Education
project National Institute for Cancer Research (Programme EXCELES, ID Project No. LX22NPO5102) Operational Programme Research, Development, and Education
Cooperatio ONCO Univerzita Karlova v Praze
Cooperatio ONCO Univerzita Karlova v Praze

BACKGROUND: The aim of this prospective study was to evaluate the role of serum IL-6 as a potential predictive biomarker of postoperative complications (POC) in elective colorectal surgery. METHOD: A total of 115 patients underwent colorectal surgery for malignancy. IL-6 was measured on the first and third postoperative days (POD1, POD3), and C-reactive protein (CRP) was measured on the POD3. POC was analysed in subgroups according to Clavien‒Dindo (CD), antibiotic (ATB) treatment, intensive care unit (ICU) and hospital length of stay. The predictive power of variables for evaluated endpoints was analysed using receiver-operating characteristic (ROC) analysis and described by area under the curve (AUC). ROC analysis was adopted for the identification of optimal cut-offs. Histological analysis was performed to verify IL-6 production by the tumour. RESULTS: Out of 115 patients who were analysed, 42% had POC. Patients with POC had significantly higher serum levels of IL-6 on POD1 (p < 0.001) and POD3 (p < 0.001). IL-6 early on POD1 as a predictor of antibiotic treatment, ICU stay and hospital stay (AUC 0.818; 0.811; 0.771) did not significantly differ from the AUC of CRP late on POD3 (0.879; 0.838, 0.752). A cut-off IL-6 value of 113 pg/ml on POD1 and 180.5 pg/ml on POD3 in severe complications (CD > 3a) resulted in 75% and 72% sensitivity, 78.6% and 99% specificity, negative predictive value 96.4% and 97% and positive predictive value 29% and 88.9%. CONCLUSION: The serum level of interleukin-6 can predict severe (CD > 3a) POC early on POD1. On POD3, IL-6 is superior to CRP in terms of high positive predictive power of severe POC. Interestingly, the advantage of IL-6 on POD1 is early prediction of the need for antibiotic treatment, ICU stay and hospital stay, which is comparable to the CRP serum level late on the third POD.

Citace poskytuje Crossref.org

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$a BACKGROUND: The aim of this prospective study was to evaluate the role of serum IL-6 as a potential predictive biomarker of postoperative complications (POC) in elective colorectal surgery. METHOD: A total of 115 patients underwent colorectal surgery for malignancy. IL-6 was measured on the first and third postoperative days (POD1, POD3), and C-reactive protein (CRP) was measured on the POD3. POC was analysed in subgroups according to Clavien‒Dindo (CD), antibiotic (ATB) treatment, intensive care unit (ICU) and hospital length of stay. The predictive power of variables for evaluated endpoints was analysed using receiver-operating characteristic (ROC) analysis and described by area under the curve (AUC). ROC analysis was adopted for the identification of optimal cut-offs. Histological analysis was performed to verify IL-6 production by the tumour. RESULTS: Out of 115 patients who were analysed, 42% had POC. Patients with POC had significantly higher serum levels of IL-6 on POD1 (p < 0.001) and POD3 (p < 0.001). IL-6 early on POD1 as a predictor of antibiotic treatment, ICU stay and hospital stay (AUC 0.818; 0.811; 0.771) did not significantly differ from the AUC of CRP late on POD3 (0.879; 0.838, 0.752). A cut-off IL-6 value of 113 pg/ml on POD1 and 180.5 pg/ml on POD3 in severe complications (CD > 3a) resulted in 75% and 72% sensitivity, 78.6% and 99% specificity, negative predictive value 96.4% and 97% and positive predictive value 29% and 88.9%. CONCLUSION: The serum level of interleukin-6 can predict severe (CD > 3a) POC early on POD1. On POD3, IL-6 is superior to CRP in terms of high positive predictive power of severe POC. Interestingly, the advantage of IL-6 on POD1 is early prediction of the need for antibiotic treatment, ICU stay and hospital stay, which is comparable to the CRP serum level late on the third POD.
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$a Conceptual development of research organisation, FNBr, 65269705 $p Ministerstvo Zdravotnictví Ceské Republiky,Czechia
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$a Conceptual development of research organisation, FNBr, 65269705 $p Ministerstvo Zdravotnictví Ceské Republiky,Czechia
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$a project National Institute for Cancer Research (Programme EXCELES, ID Project No. LX22NPO5102) $p Operational Programme Research, Development, and Education
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$a project National Institute for Cancer Research (Programme EXCELES, ID Project No. LX22NPO5102) $p Operational Programme Research, Development, and Education
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