Obesity (Silver Spring). 2014 Jan;22(1):202-10. doi: 10.1002/oby.20493.
The hypothesis that sleeve gastrectomy (SG) is not associated with an increase in mucosal colorectal cancer (CRC) biomarkers, unlike Roux-en-Y gastric bypass (RYGB), was tested.
Rectal mucosa, blood, and urine were obtained from morbidly obese patients (n = 23) before and after (median 28 months) SG, as well as from nonobese controls (n = 20). Rectal epithelial cell mitosis and apoptosis, crypt size/fission, and pro-inflammatory gene expression were measured, as well as systemic inflammatory biomarkers, including C-reactive protein (CRP).
The mean pre-operative body mass index in SG patients was 65.7 kg/m2 (24.7 kg/m2 in controls). Mean excess weight loss post-SG was 38.2%. There was a significant increase in mitosis frequency, crypt size, and crypt fission (all P < 0.01) in SG patients versus controls, as well as evidence of a chronic inflammatory state (raised CRP and mononuclear cell p65 NFκB binding), but there was no significant change in these biomarkers after SG, except CRP reduction. Macrophage migration inhibitory factor mRNA levels were increased by 39% post-SG (P = 0.038).
Mucosal biomarkers of CRC risk do not increase at 6 months following SG, unlike RYGB. Biomarkers of rectal crypt proliferation and systemic inflammation are increased in morbidly obese patients compared with controls.
测试袖状胃切除术（SG）与 Roux-en-Y 胃旁路术（RYGB）不同，不会增加黏膜结直肠癌（CRC）生物标志物的假设。
从病态肥胖患者（n = 23）术前和术后（中位数 28 个月）以及非肥胖对照者（n = 20）获得直肠黏膜、血液和尿液。测量直肠上皮细胞有丝分裂和凋亡、隐窝大小/分裂以及促炎基因表达，以及包括 C 反应蛋白（CRP）在内的全身炎症生物标志物。
SG 患者术前的平均体重指数为 65.7 kg/m2（对照组为 24.7 kg/m2）。SG 后平均超重减轻 38.2%。与对照组相比，SG 患者的有丝分裂频率、隐窝大小和隐窝分裂均显著增加（均 P < 0.01），并且存在慢性炎症状态（CRP 和单核细胞 p65 NFκB 结合升高），但 SG 后这些生物标志物除 CRP 降低外无明显变化。SG 后巨噬细胞迁移抑制因子 mRNA 水平增加 39%（P = 0.038）。
与 RYGB 不同，SG 后 6 个月黏膜 CRC 风险生物标志物没有增加。与对照组相比，病态肥胖患者的直肠隐窝增殖和全身炎症生物标志物增加。
