Abstract | OBJECTIVE: METHODS: The current study involved a total of 39 patients with pancreatic cancer (PC), who were further divided into a PC-Op group (n = 16, underwent pancreatectomy) and a PC-chemo group (n = 23, received chemotherapy). The control groups consisted of patients with hepatocellular carcinoma (n = 27, HCC group) and with benign diseases (n = 15, control group). Serial changes in TNF-alpha in whole blood stimulated by LPS were compared in various clinical settings. RESULTS: Preoperative TNF-alpha levels in the PC-Op group were significantly lower than those in the HCC and control groups (P = 0.034). The TNF-alpha variable surgical index (s-index) was defined as the ratio of the preoperative TNF-alpha level to postoperative level in the PC-Op and HCC groups. Although the TNF-alpha s-index in the PC-Op group was significantly decreased on postoperative day 1 and recovered on postoperative day 3 (P < 0.002), there were no significant changes in the TNF-alpha s-index in the HCC group. The TNF-alpha variable chemotherapeutic index (c-index) was defined as the ratio of the TNF-alpha level before to that after chemotherapy in the PC-chemo group. The TNF-alpha c-index in all 7 patients was reduced to less than 0.3 until leukopenia appeared. Patients who had an increase in TNF-alpha production ( TNF-alpha c-index >1.0) on day 3 or 7 after chemotherapy had significantly better cumulative survival than those with no increase (P < 0.033). CONCLUSIONS:
TNF-alpha production stimulated by LPS in the whole blood of patients with pancreatic cancer was low. Surgical stress and depressed immunocompetence might induce such profound decreases. A method of assessing the capability of leukocytes, particularly macrophages, to produce TNF-alpha could be useful for prognostis and for monitoring immunocompetence in patients with pancreatic cancer who have undergone chemotherapy.
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Authors | Naoyoshi Terakawa, Sohei Satoi, Soichiro Takai, Hiroaki Yanagimoto, Kanji Takahashi, Yutaka Komiyama, Kwon A-Hon, Yasuo Kamiyama, Hakuo Takahashi |
Journal | Pancreas
(Pancreas)
Vol. 33
Issue 1
Pg. 31-7
(Jul 2006)
ISSN: 1536-4828 [Electronic] United States |
PMID | 16804410
(Publication Type: Clinical Trial, Comparative Study, Journal Article)
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Chemical References |
- Antineoplastic Agents
- Lipopolysaccharides
- Tumor Necrosis Factor-alpha
- Deoxycytidine
- Fluorouracil
- Gemcitabine
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents
(therapeutic use)
- Carcinoma, Hepatocellular
(blood, immunology)
- Deoxycytidine
(analogs & derivatives, therapeutic use)
- Female
- Fluorouracil
(therapeutic use)
- Humans
- Immunity, Cellular
- Lipopolysaccharides
- Liver Neoplasms
(blood, immunology)
- Macrophages
(immunology, metabolism)
- Male
- Middle Aged
- Monocytes
(immunology, metabolism)
- Pancreatectomy
- Pancreatic Neoplasms
(blood, drug therapy, immunology, surgery)
- Survival Analysis
- Tumor Necrosis Factor-alpha
(biosynthesis)
- Gemcitabine
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