NEW YORK (Reuters Health), May 16 - Production of high levels of interleukin-6 (IL-6) by mononuclear blood cells in response to lipopolysaccharide (LPS) stimulation in vitro is associated with shorter survival in patients about to undergo primary surgery for colorectal cancer, Swedish investigators have shown.
Dr. Birgitta Clinchy and colleagues at University Hospital Linköping isolated peripheral blood mononuclear cells (PBMC) from 39 patients scheduled for colorectal surgery. The cells were cultured for 24 hours in the presence of autologous serum and LPS.
The investigators report, in the May 1st issue of Cancer, that production of high levels of IL-6 was associated with a poor prognosis.
Eight of the 13 patients who produced more than 5,000 pg/mL of IL-6 preoperatively died from cancer during 54 months of follow-up. There were no cancer-related deaths in the 21 patients who produced 5,000 pg/mL or less IL-6. (Five patients died of other causes during follow-up.)
Dr. Clinchy and colleagues say that high IL-6 production pre-operatively is an independent prognostic factor in survival after surgery for colorectal cancer.
"A determination of high IL-6 production identifies patients at high risk of recurrence," Dr. Clinchy told Reuters Health. "Pre- and/or postoperative medical treatment can be offered to these patients."
Furthermore, "Good risk patients after standard surgery can be identified by LPS-induced IL-6 production. If a more aggressive surgical approach than standard surgery is considered, this can be restricted to patients at high risk of recurrence," which would be those with high LPS-induced IL-6 production.
By Martha Kerr
Last Updated: 2007-05-15 14:11:16 -0400 (Reuters Health)
Cancer 2007;109:1742-1749.
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![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnieeurope.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
