Wierdak Mateusz, Pisarska Magdalena, Kuśnierz-Cabala Beata, Witowski Jan, Major Piotr, Ceranowicz Piotr, Budzyński Andrzej, Pędziwiatr Michał
1 2nd Department of General Surgery, Jagiellonian University Medical College , Kraków, Poland .
2 Centre for Research , Training and Innovation in Surgery (CERTAIN Surgery), Kraków, Poland .
Surg Infect (Larchmt). 2018 Aug/Sep;19(6):622-628. doi: 10.1089/sur.2018.105. Epub 2018 Jul 13.
Our aim was to evaluate the usefulness of serum amyloid A (SAA) measurements in comparison with C-reactive protein (CRP) in the early prediction of infectious complications among patients undergoing laparoscopic surgery for colorectal cancer Methods: Consecutive patients undergoing laparoscopic resection for colorectal cancer were analyzed prospectively. All subjects had the Enhanced Recovery After Surgery protocol implemented. Blood samples were taken from all patients and SAA and CRP were measured on the day of surgery and on the three consecutive post-operative days (PODs). Patients were divided into two groups (Group 1 without complications, Group 2 with complications), and these groups were compared.
The study included 81 patients (61 in Group 1 and 20 in Group 2). Starting from POD2, significant differences between the groups were observed for both SAA and CRP. On POD2, the median CRP values were 116.7 mg/L and 256.9 mg/L in Groups 1 and 2, respectively (p = 0.00002). On POD3, the median SAA concentration was 445 mg/L in Group 1 and 1,412 mg/L in Group 2 (p = 0.00003). The CRP concentrations were 80.2 mg/L and 247.1 mg/L in Groups 1 and 2, respectively (p = 0.00001). A receiver operating characteristic (ROC) curve analysis showed that measurements of POD3 had the highest specificity and sensitivity with no significant differences between CRP and SAA (on POD3 for SAA sensitivity 83.3% and specificity 94%; for CRP: sensitivity 88% and specificity 86%).
Measurements of SAA are useful in predicting infectious complications even on the early post-operative days. It has characteristics similar to CRP, and its best values are reached on POD3.
我们的目的是评估血清淀粉样蛋白A（SAA）检测相较于C反应蛋白（CRP）在接受腹腔镜结直肠癌手术患者感染性并发症早期预测中的作用。方法：对连续接受腹腔镜结直肠癌切除术的患者进行前瞻性分析。所有受试者均实施了术后加速康复方案。在手术当天及术后连续三天（POD）采集所有患者的血样，检测SAA和CRP。将患者分为两组（第1组无并发症，第2组有并发症），并对两组进行比较。
该研究纳入81例患者（第1组61例，第2组20例）。从POD2开始，两组在SAA和CRP方面均观察到显著差异。在POD2时，第1组和第2组的CRP中位数分别为116.7mg/L和256.9mg/L（p = 0.00002）。在POD3时，第1组的SAA中位数浓度为445mg/L，第2组为1412mg/L（p = 0.00003）。第1组和第2组的CRP浓度分别为80.2mg/L和247.1mg/L（p = 0.00001）。受试者工作特征（ROC）曲线分析表明，POD3检测的特异性和敏感性最高，CRP和SAA之间无显著差异（POD）3时SAA的敏感性为83.3%，特异性为94%；CRP的敏感性为88%，特异性为86%）。
SAA检测即使在术后早期也有助于预测感染性并发症。它具有与CRP相似的特征，在POD3时达到最佳值。
