Blood interleukin 12 as preoperative predictor of fatal postoperative sepsis after neoadjuvant radiochemotherapy

Br J Surg. 2006 Oct;93(10):1283-9. doi: 10.1002/bjs.5404.

Abstract

Introduction: The value of preoperative whole-blood interleukin (IL) 12 levels in predicting death from postoperative sepsis was evaluated, in patients stratified by underlying malignancy, neoadjuvant tumour treatment and surgical procedure.

Methods: Blood samples were collected from 1444 patients before major surgery. Whole blood was incubated with Escherichia coli lipopolysaccharide (LPS) and IL-12 production in supernatants was assessed by enzyme-linked immunosorbent assay. The prognostic impact of ability to synthesize IL-12 before surgery was investigated in patient subgroups with respect to sepsis-related mortality using multivariate binary logistic regression analysis.

Results: IL-12 synthesizing capability in patients who survived sepsis was significantly higher than that in patients who developed fatal sepsis (P = 0.006). In multivariate analysis only IL-12 was associated with a lethal outcome from postoperative sepsis (P = 0.006). The prognostic impact of IL-12 was evident in patients with underlying malignancy (P = 0.011) and in those who had undergone neoadjuvant tumour treatment (P = 0.008). When patients were analysed according to the type of neoadjuvant therapy, preoperative ability to synthesize IL-12 had a significant prognostic impact in patients who had neoadjuvant radiochemotherapy (P = 0.026), but not in those who had neoadjuvant chemotherapy.

Conclusion: IL-12 production after stimulation of whole blood with LPS appears to be useful for the preoperative assessment of risk of sepsis-related death after operation in patients who have undergone neoadjuvant radiochemotherapy.

MeSH terms

  • Biomarkers / blood
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Digestive System Neoplasms / therapy*
  • Female
  • Humans
  • Interleukin-12 / blood*
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Postoperative Complications / blood
  • Postoperative Complications / microbiology*
  • Postoperative Complications / prevention & control*
  • Predictive Value of Tests
  • Preoperative Care / methods
  • Prospective Studies
  • Risk Factors
  • Sepsis / blood
  • Sepsis / prevention & control*

Substances

  • Biomarkers
  • Interleukin-12