Pro-inflammatory cytokine release by peripheral blood mononuclear cells from patients with advanced pancreatic cancer: relationship to acute phase response and survival

Oncol Rep. 2009 Apr;21(4):1091-5. doi: 10.3892/or_00000328.


The acute phase protein response (APPR) and peripheral blood mononuclear cell-derived inflammatory cytokine production was assessed in patients with advanced pancreatic cancer and age-matched healthy volunteers. We examined the relationship between the APPR, cytokine production and survival in these patients. Forty-two patients with pancreatic cancer cachexia and twelve age-matched healthy controls were recruited. The nutritional status, Karnofsky performance score, C reactive protein (CRP), serum interleukin-6, and in vitro monocyte interleukin-1 and interleukin-6 production were measured. The dates of death of the pancreatic cancer patients were subsequently obtained and appropriate patient variables at baseline were entered into a Cox's proportional hazards model. The cancer patients had significantly lower: body mass index, Karnofsky performance score, serum albumin and elevated CRP and stimulated interleukin-6 production. Both univariate and multivariate analysis demonstrated a strong association between tumour stage, CRP, stimulated interleukin-6 production and survival. Monocytes in cachectic pancreatic cancer patients are primed to produce high levels of interleukin-6 when stimulated. Overproduction of interleukin-6 has a negative impact on survival. Decreased survival is associated with an elevated APPR. While the elevated APPR is probably related to locally produced interleukin-6 in the liver, it seems possible that locally and systemically produced interleukin-6 influences survival.

MeSH terms

  • Acute-Phase Reaction*
  • Aged
  • C-Reactive Protein / analysis
  • Cytokines / blood*
  • Eicosapentaenoic Acid / blood
  • Female
  • Humans
  • Interleukin-1 / blood
  • Interleukin-6 / blood
  • Leukocytes, Mononuclear / immunology*
  • Male
  • Pancreatic Neoplasms / immunology*
  • Pancreatic Neoplasms / mortality


  • Cytokines
  • Interleukin-1
  • Interleukin-6
  • C-Reactive Protein
  • Eicosapentaenoic Acid