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