Department of Clinical Chemistry, Sestre Milosrdnice University Hospital Center, Zagreb 10000, Croatia.
Department of General and Abdominal Surgery, St. Anna Hospital, Sulzbach-Rosenberg 92237, Germany.
Chin Med J (Engl). 2017 Nov 20;130(22):2691-2696. doi: 10.4103/0366-6999.218022.
Major abdominal surgery, including colorectal cancer (CRC) surgery, leads to systemic inflammatory response syndrome that can be detected and monitored with inflammatory markers testing. The aims of the study were to evaluate the usefulness of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) in following the inflammatory response in CRC surgery and postoperative period, as well as to determine if duration of the surgery and the time that the colon has been opened during the surgery (open colon time [OCT]) reflect a larger surgical stress through inflammatory markers rise.
The study included 20 patients who underwent CRC surgery and 19 healthy volunteers from June 2011 to September 2012. We determined inflammatory markers 1 day before surgery (T0), 24 h (T1), 48 h (T2), and 7 days after the surgery (T3). All statistical analyses were calculated using MedCalc Statistical Software version 14.8.1 (MedCalc Software bvba, Ostend, Belgium).
Concentrations of CRP, PCT, and IL-6 in all measurement times were statistically different and sTREM-1 did not yield statistical significance. A weak positive correlation was found between IL-6 in T1 and T2 with the duration of the surgery (T1: r = 0.4060, P < 0.0001; T2: r = 0.3430, P < 0.0001) and OCT (T1: r = 0.3640, P < 0.0001, T2: r = 0.3430, P < 0.0001). A weak positive correlation between CRP in T2 and OCT (r = 0.4210, P < 0.0001) was also found. The interconnectivity of tested parameters showed a weak positive correlation between CRP and IL-6 in T1 (r = 0.3680; P < 0.0001), moderate positive correlation in T2 (r = 0.6770; P < 0.0001), and a strong positive correlation in T3 (r = 0.8651; P < 0.0001).
CRP, IL-6, and PCT were shown to be reliable for postoperative monitoring. Simultaneous determination of CRP and IL-6 might not be useful as they follow similar kinetics. sTREM-1 might not be useful in CRC postoperative monitoring.
www.ClinicalTrials.gov, NCT01244022;https://www.clinicaltrials.gov/ct2/show/NCT01244022?term=01244022&rank=1.
包括结直肠癌（CRC）手术在内的重大腹部手术会导致全身炎症反应综合征，可以通过炎症标志物检测来检测和监测。本研究的目的是评估可溶性髓系细胞触发受体-1（sTREM-1）、白细胞介素-6（IL-6）、降钙素原（PCT）和 C 反应蛋白（CRP）在 CRC 手术和术后期间监测炎症反应的有用性，以及确定手术持续时间和结肠在手术过程中开放的时间（OCT）是否通过炎症标志物的升高反映出更大的手术应激。
该研究纳入了 2011 年 6 月至 2012 年 9 月期间接受 CRC 手术的 20 名患者和 19 名健康志愿者。我们在术前 1 天（T0）、术后 24 小时（T1）、48 小时（T2）和术后 7 天（T3）测定炎症标志物。所有统计分析均使用 MedCalc 统计软件版本 14.8.1（MedCalc Software bvba，比利时奥斯坦德）进行计算。
在所有测量时间点，CRP、PCT 和 IL-6 的浓度均有统计学差异，而 sTREM-1 无统计学意义。在 T1 和 T2 中发现了 IL-6 与手术持续时间之间的弱正相关（T1：r = 0.4060，P < 0.0001；T2：r = 0.3430，P < 0.0001）和 OCT（T1：r = 0.3640，P < 0.0001，T2：r = 0.3430，P < 0.0001）。在 T2 中也发现了 CRP 与 OCT 之间的弱正相关（r = 0.4210，P < 0.0001）。测试参数的相互连接性在 T1 中显示 CRP 和 IL-6 之间存在弱正相关（r = 0.3680；P < 0.0001），在 T2 中存在中度正相关（r = 0.6770；P < 0.0001），在 T3 中存在强正相关（r = 0.8651；P < 0.0001）。
CRP、IL-6 和 PCT 被证明是术后监测的可靠指标。CRP 和 IL-6 同时测定可能没有用处，因为它们具有相似的动力学。sTREM-1 可能不适用于 CRC 术后监测。
