Functional and morphological effects of tumour necrosis factor alpha in an interleukin 6-producing pulmonary large cell carcinoma with sarcomatoid features

Evaluation of interleukin-6 in bronchoalveolar lavage fluid and serum of patients with lung cancer

Increased levels of serum interleukin 6 (IL-6) are found in patients with lung cancer, and it has been shown that this is part of a systemic inflammatory response syndrome. This study was designed to measure IL-6 levels in bronchoalveolar lavage (BAL) fluid of patients with lung cancer and to describe the relationship of BAL fluid IL-6 to the known systemic increase in IL-6. Increased levels of BAL fluid IL-6 can be found in patients with lung cancer as compared with patients with chronic obstructive pulmonary disease who have acute infection (P = .007). In patients with cancer, no correlation between BAL fluid IL-6 and serum IL-6 was found (P = .8). BAL fluid IL-6 did not correlate with the number of lymphocytes or macrophages found in this fluid. BAL fluid IL-6 does not correlate with tumor size. Although serum IL-6 was higher in patients with extensive stage small cell lung cancer as compared with levels in patients with limited stage disease (P = .06), their corresponding BAL fluid levels were not different (P = .9). Serum IL-6 correlated with other acute phase reactants. This study thus demonstrates the feasibility of utilizing BAL fluid analysis for local cytokine/tumor marker production in lung carcinoma. It also shows that a local increase in IL-6 in the BAL fluid is independent of the systemic inflammatory response syndrome, whereas the serum increase in IL-6 is part of this syndrome.

Involvement of interleukin-6 in the elevation of plasma fibrinogen levels in lung cancer patients

BACKGROUND

Involvements of interleukin-6 (IL-6) and fibrinogen in cancer development have been independently studied. However, the association of these molecules in cancer patients remains uncertain. This study was conducted to clarify the association according to the clinicopathological characteristics of lung cancer patients.

METHODS

Serum IL-6 levels assayed in 339 patients without pleural effusion were assessed according to clinical stage, histological type of the cancer and levels of fibrin (ogen) degradation products (FDP), and C-reactive protein (CRP).

RESULTS

Elevations of serum IL-6 levels more than 4 pg/ml were found in 37.8% of all patients. According to the clinical stage and histological type, the elevations were significantly more frequent in the advanced stage (44.7%), in squamous cell (49.1%) and large cell carcinomas (63.6%). Similarly, the frequency of the elevated cases (> 400 mg/dl) and the mean value of the fibrinogen level were also higher in the advanced stage (54.2%, 455.0 mg/dl) and large cell carcinoma (54.6%, 459.3 mg/dl), respectively. The elevations of fibrinogen, FDP and CRP levels were found to be related to those of the IL-6 level.

CONCLUSION

In lung cancer, serum IL-6 elevations are particularly frequent in the advanced stages of patients with squamous cell and large cell carcinoma, which are associated with the elevated levels of fibrinogen, suggesting a possibility that IL-6 was involved not only directly, but also indirectly, through regulating plasma fibrinogen with promotion of cancer development in vivo.

Cadherin expression in melanocytic naevi and malignant melanomas

An immunocytochemical study has been undertaken of cadherin expression in 11 benign melanocytic naevi and 14 malignant melanomas. Anti-pan-cadherin rabbit antibodies, which recognize multiple cadherin subtypes, demonstrated cadherin expression of moderate or strong intensity in 8 of 11 naevi. Expression was restricted to the more superficial melanocytes which possessed abundant cytoplasm (type A melanocytes). More deeply located melanocytes possessing little cytoplasm (type B melanocytes) or having a spindle cell morphology (type C melanocytes) lacked detectable pan-cadherin expression. The monoclonal antibody HECD-1 detected weak E-cadherin immunostaining in all 11 naevi, expression again being limited, with a single exception, to type A melanocytes. Cadherin immunostaining of moderate or strong intensity was detected by the pan-cadherin antibody in all 14 malignant melanomas. In contrast to naevi, cadherin expression in melanomas frequently extended into the deepest portions of the tumours. E-cadherin immunostaining in malignant melanomas was generally much stronger than that seen in naevi, often being of comparable intensity to the pan-cadherin staining. In summary, cadherins are frequently expressed in melanocytic tumours. In naevi, cadherin expression is related to the degree of melanocytic maturation. Cadherin expression, and particularly E-cadherin expression, tends to be greater in malignant melanomas than in naevi.