Matsuda Akihisa, Yamada Marina, Matsumoto Satoshi, Sakurazawa Nobuyuki, Yamada Takeshi, Matsutani Takeshi, Miyashita Masao, Uchida Eiji
Department of Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan.
Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
Surg Today. 2018 Oct;48(10):936-943. doi: 10.1007/s00595-018-1675-2. Epub 2018 May 17.
Lysophosphatidylcholine (LPC), which is generated from phosphatidylcholine (PC) and metabolized by autotaxin (ATX), modulates immune responses via its anti-inflammatory property. We investigated the association between LPC and postoperative complications (POCs) after colorectal cancer surgery (CRC).
The subjects of this study were 43 patients who underwent surgery for CRC. Peripheral blood samples were collected preoperatively and immediately after surgery, and on postoperative days (PODs) 1, 3, 5, and 7. Patients were divided into a No-POC group (n = 33) and a POC group (n = 10). Blood LPC, IL-6, PC, and ATX levels were measured by specific enzymatic assays or ELISA.
The postoperative to preoperative LPC ratios were lowest on POD 1 in both groups. The POC group had significantly lower LPC ratios throughout the perioperative period than the No-POC group. The LPC ratios were inversely correlated with IL-6. The predictive impact of LPC ratios on POCs was demonstrated by ROC analysis (cut-off 51.2%, AUC 0.798) and multivariate analysis (OR 15.1, P = 0.01). The postoperative PC ratios decreased more after surgery in the POC group. ATX levels did not change significantly in either group.
Decreased postoperative LPC is associated with increased postoperative inflammatory response and POCs. The decreased PC supply to the circulation is a mechanism of the postoperative LPC decrease.
溶血磷脂酰胆碱（LPC）由磷脂酰胆碱（PC）生成并由自分泌运动因子（ATX）代谢，通过其抗炎特性调节免疫反应。我们研究了LPC与结直肠癌手术（CRC）后术后并发症（POC）之间的关联。
本研究的受试者为43例行CRC手术的患者。术前、术后即刻以及术后第1、3、5和7天采集外周血样本。患者分为无POC组（n = 33）和POC组（n = 10）。通过特定酶法或酶联免疫吸附测定（ELISA）测量血液中LPC、白细胞介素-6（IL-6）、PC和ATX水平。
两组术后与术前的LPC比值在术后第1天均最低。POC组在围手术期的LPC比值显著低于无POC组。LPC比值与IL-6呈负相关。LPC比值对POC的预测影响通过ROC分析（临界值51.2%，曲线下面积[AUC] 0.798）和多变量分析（比值比[OR] 15.1，P = 0.01）得以证实。POC组术后PC比值下降得更多。两组中ATX水平均无显著变化。
术后LPC降低与术后炎症反应增加和POC相关。循环中PC供应减少是术后LPC降低的一种机制。
