Interleukin 6 and its relationship to clinical parameters in patients with malignant pleural mesothelioma

Our plain-English summary of Interleukin 6 and its relationship to clinical parameters in patients with malignant pleural mesothelioma, by T. Nakano, A.P. Chahinian, M. Shinjo, et al (British Journal of Cancer, 1998).

The study

• Authors: T. Nakano, A.P. Chahinian, M. Shinjo, A. Tonomura, M. Miyake, N. Togawa, K. Ninomiya, K. Higashino
• Journal: British Journal of Cancer
• Published: 1998;77(6):907-12
• Cited by: 91 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

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.

In plain English

This study measured interleukin 6 (IL-6), an immune signalling protein, in 25 patients with newly diagnosed malignant pleural mesothelioma, 17 patients with lung adenocarcinoma and cancer cells in the pleural fluid, and 15 patients with tuberculous pleurisy. It did not report asbestos exposure. Blood IL-6 and several inflammation-related proteins, including C-reactive protein and fibrinogen, were significantly higher in the mesothelioma group than in the adenocarcinoma group, and IL-6 levels correlated with these proteins. A high platelet count was found in 12 of 25 mesothelioma patients (48%), 5 of 15 tuberculous pleurisy patients (33%) and 2 of 17 adenocarcinoma patients (12%). Among mesothelioma patients, blood IL-6 correlated with platelet count. Pleural fluid was measured in 13 mesothelioma patients. In them, IL-6 was about 60 to 1400 times the blood level and significantly higher than in adenocarcinoma fluid, but it was higher still in tuberculous fluid. Survival did not differ significantly by blood IL-6 level. The authors concluded that IL-6 leaks from the pleural fluid into the bloodstream and causes inflammatory reactions. They also concluded that markedly raised pleural fluid IL-6 argues against adenocarcinoma, though tuberculous pleurisy shows similar profiles.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Clinical comparison of three patient groups using laboratory measurements of blood and pleural fluid, with a survival comparison and a description of one patient's course
• Who was studied: Three groups: 25 patients with newly diagnosed malignant pleural mesothelioma, 17 with newly diagnosed lung adenocarcinoma and cytology-positive pleural effusion, and 15 with tuberculous pleurisy. The authors were at Hyogo College of Medicine, Japan, and Mount Sinai Medical Center, New York. The article does not state where or when the patients were seen.
• Exposure: Asbestos or other fiber exposure is not reported. The study measured IL-6, tumour necrosis factor-alpha and acute-phase proteins in blood (serum) and pleural fluid collected before chemotherapy.
• Main results:
  • Serum IL-6, C-reactive protein, alpha-1 acid glycoprotein, alpha-1 antitrypsin and fibrinogen were significantly higher in the mesothelioma patients than in the lung adenocarcinoma patients. Pre-albumin did not differ significantly.
  • Serum IL-6 was over 100 pg/ml in 6 of the 25 mesothelioma patients.
  • In mesothelioma patients, serum IL-6 correlated positively with C-reactive protein (r = 0.69, P less than 0.01) and fibrinogen (r = 0.71, P less than 0.01).
  • In mesothelioma patients, serum IL-6 also correlated with alpha-1 antitrypsin (r = 0.75, P less than 0.01) and alpha-1 acid glycoprotein (r = 0.55, P less than 0.05).
  • Thrombocytosis (platelets above 400 x 10^9 per litre) occurred in 12 of 25 mesothelioma patients (48%), 5 of 15 tuberculous pleurisy patients (33%) and 2 of 17 lung adenocarcinoma patients (12%).
  • Platelet counts did not differ significantly between the mesothelioma and tuberculous pleurisy patients.
  • Serum IL-6 correlated significantly with platelet count (r = 0.76, P less than 0.01).
  • In mesothelioma patients, pleural fluid IL-6 was about 60 to 1400 times higher than serum IL-6. The two levels tended to go together, but this relationship was not statistically significant.
  • Pleural fluid IL-6 was significantly higher in mesothelioma patients than in lung adenocarcinoma patients, and higher still in tuberculous pleurisy. Medians were 3813 pg/ml in mesothelioma (n = 13), 359.1 in adenocarcinoma (n = 17) and 22212 in tuberculous pleurisy (n = 15).
  • Tumour necrosis factor-alpha in pleural fluid was undetectable or very low.
  • Mesothelioma patients with serum IL-6 of 100 pg/ml or more did not have significantly different survival from those with lower levels.
  • One mesothelioma patient had a partial response to cisplatin and irinotecan, with tumour progression at 5 weeks. This patient's serum IL-6, C-reactive protein and platelet count fell to a low point on day 14 and then rose again.
• The authors' conclusion: The authors concluded that mesothelioma patients have large amounts of IL-6 in the pleural fluid, which leaks into the bloodstream and induces clinical inflammatory reactions. They also concluded that a markedly increased pleural fluid IL-6 argues against adenocarcinoma with pleural effusion.
• Limitations the authors state:
  • IL-6 levels overlapped between mesothelioma and adenocarcinoma.
  • The profiles are not specific to mesothelioma, and confusion with tuberculous pleurisy remains possible.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Glycoprotein, Mesothelioma, Lung Adenocarcinoma, Cytology, Pleural Effusion, Adenocarcinoma, Tuberculous pleurisy.

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