Turgunov Yermek, Ogizbayeva Alina, Akhmaltdinova Lyudmila, Shakeyev Kayrat
Department of Surgical Diseases, NJSC "Karaganda Medical University", Karaganda, Kazakhstan.
Collective Use Laboratory of the Research Center, NJSC "Karaganda Medical University", Karaganda, Kazakhstan.
Contemp Oncol (Pozn). 2021;25(3):198-203. doi: 10.5114/wo.2021.110051. Epub 2021 Oct 14.
In this pilot study lipopolysaccharide-binding protein (LBP) levels were assessed as a possible risk factor for development of systemic inflammatory response syndrome (SIRS) and infectious and inflammatory complications in colorectal cancer (CRC) patients after surgery.
For LBP determination venous blood was taken 1 hour before the surgery and 72 hours after it. All patients were stratified by the presence or absence of acute bowel obstruction (ABO), SIRS and complications.
36 patients with CRC participated in the study. The LBP level before surgery was 879.8 ± 221.8 ng/ml (interquartile range (IQR) 749.3-1028.8); on the 3 day it was 766.5 ± 159.4 ng/ml (IQR 669.5-847.6), which was a statistically significant decrease ( = 0.004). A decrease in LBP level by more than 280 ng/ml increases the probability of SIRS and complications in operated CRC patients (OR 6.6, 95% CI: 1.1-40.9 and OR 12.0, 95% CI: 1.8-80.4, respectively). In patients with ABO in the presence of SIRS, the LBP value decreased more than in those without SIRS ( = 0.046).
This study demonstrated that the LBP level in the operated CRC patients tends to decrease on the 3 day after surgery. A bigger decrease in LBP level increases the probability of SIRS and postoperative infectious and inflammatory complications. Therefore, further studies with larger numbers of patients are required.
在这项初步研究中,评估脂多糖结合蛋白(LBP)水平,将其作为结直肠癌(CRC)患者术后发生全身炎症反应综合征(SIRS)以及感染和炎症并发症的一个可能危险因素。
为测定LBP,在手术前1小时和手术后72小时采集静脉血。所有患者根据是否存在急性肠梗阻(ABO)、SIRS和并发症进行分层。
36例CRC患者参与了该研究。手术前LBP水平为879.8±221.8 ng/ml(四分位间距(IQR)749.3 - 1028.8);术后第3天为766.5±159.4 ng/ml(IQR 669.5 - 847.6),这是一个具有统计学意义的下降(P = 0.004)。手术的CRC患者中,LBP水平下降超过280 ng/ml会增加发生SIRS和并发症的概率(OR分别为6.6,95%CI:1.1 - 40.9和OR 12.0,95%CI:1.8 - 80.4)。在存在SIRS的ABO患者中,LBP值下降幅度比无SIRS的患者更大(P = 0.046)。
本研究表明,手术的CRC患者术后第3天LBP水平往往会下降。LBP水平下降幅度越大,发生SIRS以及术后感染和炎症并发症的概率越高。因此,需要开展更多患者参与的进一步研究。