Changes in Tumor Nekrosis Factor Alpha and Interleukin 6 Levels in Patients with Obstructive Jaundice due to Pancreatobiliary Cancer Who Underwent Biliary Drainage
Abstract: Obstructive jaundice
represents the most common complication of biliary tract malignancy.
Obstructive jaundice causes releases of proinflammatory cytokine. There has
been controversy about effect of biliary drainage on the change in
proinflammatory cytokine level in pancreatobiliary cancer patients. The present
study was designed to determine levels of tumor necrosis factor alpha
(TNF-alfa) and interleukin 6 (IL-6) in preprocedure of either endoscopic
retrograde cholangio pancreatography (ERCP) or percutaneous transhepatic
biliary drainage (PTBD) and postprocedure of them in obstructive jaundice
patient caused by pancreatobiliary cancer.
Method: The study method was before-and-after case study design with
consecutive sampling. Blood was collected five days prior to either endoscopic
retrograde cholangio pancreatography (ERCP) procedure or percutaneus
transhepatic biliary drainage (PTBD) procedure and five days after either of
them. Enzyme linked immunosorbed assay (ELISA) was used to determine TNF-alfa
and IL-6.
Results: Forty subjects were included in this study which consisted of 22
men and 18 women. The age was 55.3 (SD 13.7) years old. According to the
results of imaging and endoscopy procedure, twenty-two people were diagnosed
cholangicarcinoma, ten people were diagnosed ampulla vateri and eigth people
were diagnosed pancreatic tumor. In preprocedure, the TNF-alfa concentration
was 4.81 (SD 2.91) pg/mL, the IL-6 concentration was 7.79 (SD 1.57) pg/mL and
the bilirubin concentration was 15.5 (SD
6,9) mg%. In postprocedure, the TNF-alfa concentration was
8.05 (SD 6.7) pg/mL, there was a
significant increase in TNF-alfa concentration (p = 0.02). However, IL-6
concentration was 7.75 (SD 1.76) pg/mL, there was not any significant chance in
IL-6 concentration (p = 0.52).
The bilirubin concentration was
11.3 (SD 6,5) mg%.
Conclusion: There was a significant increase in mean concentration value
of TNF-alfa after biliary drainage procedure.
On the other hand there was not any significant decrease in the mean concentration value of IL-6
after biliary drainage procedure.
Keywords: obstructive
jaundice; pancreaticobilliary cancer; tumor necrosis factor alpha (TNF-alfa);
interleukin 6 (IL-6); endoscopic retrograde cholangio pancreatography (ERCP);
percutaneus transhepatic biliary drainage (PTBD)
Author: Adang Sabarudin, Rino
Alvani Gani, Murdani Abdullah, Cleopas Martin Rumende
Journal Code: jpkedokterangg160410
