Background/aims: To determine whether increases in soluble tumor necrosis factor receptors (sTNFRs) are associated with the levels of cytokines and proteinases in patients undergoing major surgery.

Methodology: Eleven patients who underwent esophagectomy for squamous cell carcinoma of the thoracic esophagus were studied. The circulating blood concentrations of interleukin-6 (IL-6), IL-8, sTNF-R55, sTNF-R75, elastase/al-proteinase inhibitor complex (elastase) and matrix metalloproteinase-9 (MMP-9) were measured by ELISA or EIA before surgery, just after surgery, and on postoperative days (POD) 1 and 3.

Results: The levels of serum IL-6, plasma IL-8, plasma elastase and plasma MMP-9 increased significantly after surgery, peaking just after surgery or on POD 1 and then declining. In contrast, the serum levels of sTNFRs increased approximately 2-fold just after surgery compared with the preoperative values and then remained elevated. The IL-6 level correlated with the levels of sTNF-R55 and sTNF-R75 after surgery.

Conclusions: These results suggest that increases of IL-6, serine proteinases and MMPs may be involved in the upregulation of sTNFRs in patients undergoing major surgery.

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