Abstract
The relationship between interleukin 6 (IL-6) levels and clinical parameters was studied in 25 patients with malignant pleural mesothelioma. The serum levels of IL-6, C-reactive protein, alpha1-acid glycoprotein and fibrinogen were significantly higher in mesothelioma than in lung adenocarcinoma with cytology-positive pleural effusion. Serum IL-6 levels correlated with the levels of the acute-phase proteins. We demonstrated a high incidence of thrombocytosis (48%) and a significant correlation between platelet count and the serum IL-6 level. The level of IL-6 in the pleural fluid of patients with mesothelioma was significantly higher than in the pleural fluid of patients with adenocarcinoma, and was about 60-1400 times higher than in the serum. However, even higher levels of IL-6 in the pleural fluid and of thrombocytosis were found in patients with tuberculous pleurisy. These results indicate that large amounts of IL-6 from the pleural fluid of patients with mesothelioma leak into the systemic circulation and induce clinical inflammatory reactions. These profiles are not specific to mesothelioma as similar profiles are found in patients with tuberculous pleurisy. However, the detection of a markedly increased level of IL-6 in pleural fluid argues against a diagnosis of adenocarcinoma.
Highlights
We investigated the clinical responses to interleukin 6 (IL-6) production in patients with malignant pleural mesothelioma and the differences in levels of IL-6 and acute-phase protein (APP) in patients with mesothelioma, with lung adenocarcinoma with a cytology-positive pleural effusion and in patients with tuberculous pleurisy
We studied 25 patients with newly diagnosed malignant pleural mesothelioma, 17 patients with newly diagnosed lung adenocarcinoma and cytology-positive pleural effusion and 15 patients with tuberculous pleurisy
We found a significant correlation between serum IL-6 levels and platelet counts in patients with malignant pleural mesothelioma, and even higher levels of IL-6 in the pleural fluid of patients with tuberculous pleurisy
Summary
The concentrations of IL-6 (Toray, Tokyo, Japan) and tumour necrosis factor-a (TNF-ca) (Otsuka, Tokyo, Japan) were measured using the commercially available ELISA kit. In age-matched normal subjects, IL-6 and TNF-a were undetectable in the serum or at the limit of detection of the assay. Determinations of CRP (Eiken-Kagaku, Tokyo, Japan), adenosine deaminase (ADA) (Maruno, Osaka, Japan), fibrinogen (International Reagents, Kobe, Japan), AAT, AGP and pre-albumin concentrations (Behringwerke, Germany) were performed using commercially available kits. In accordance with the information provided by our institution, the normal values of CRP, ADA, fibrinogen, AGP, AAT and pre-albumin in serum are
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