The diagnostic value of proinflammatory cytokines and acute phase proteins in postoperative sepsis

The plasma levels of some inflammatory cytokines (interleukin (IL)-1 beta, IL-6, IL-8, tumour necrosis factor (TNF)-alpha) and acute phase proteins were monitored in 20 patients after the planned resection of colorectal cancer with uncomplicated healing, and compared with 10 patients with postoperative sepsis. During the first 24 hours there was a significant increase in serum IL-6 (1125+/-240 ng/l), and TNF alpha (205+/-22 ng/l). Serum IL-1 beta was stable without elevation. IL-8 raised after 36-48 hours, ranging 520+/-200 ng/l. The first APP that could be detected are CRP (ranging 110+/-59 mg/l) and a-1-antitrypsin (2,79+/-0,6 mg/l), both reach the highest concentrations after 72 hours after the operation. All these parameters without IL-1 beta statistically significantly differed from the 2nd group. To distinguish the early postoperative septic complication we recommend to observe IL-6 and IL-8 in 24 - 72 hours, and CRP after 72 hours. We recommend this monitoring on patients with the high risk of the early postoperative septic complications.