Shantha Kumara H M C, Shah Abhinit, Miyagaki Hiromichi, Yan Xiaohong, Cekic Vesna, Hedjar Yanni, Whelan Richard L
Division of Colon and Rectal Surgery, Department of Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, United States.
Gastroenterological Surgery, Osaka University, Suita, Japan.
Front Surg. 2021 Nov 8;8:745875. doi: 10.3389/fsurg.2021.745875. eCollection 2021.
Human Keratinocyte Growth Factor (KGF) is an FGF family protein produced by mesenchymal cells. KGF promotes epithelial cell proliferation, plays a role in wound healing and may also support tumor growth. It is expressed by some colorectal cancers (CRC). Surgery's impact on KGF levels is unknown. This study's purpose was to assess plasma KGF levels before and after minimally invasive colorectal resection (MICR) for CRC. To determine plasma KGF levels before and after minimally invasive colorectal resection surgery for cancer pathology. CRC MICR patients (pts) in an IRB approved data/plasma bank were studied. Pre-operative (pre-op) and post-operative (post-op) plasma samples were taken/stored. Late samples were bundled into 7 day blocks and considered as single time points. KGF levels (pg/ml) were measured ELISA (mean ± SD). The Wilcoxon paired -test was used for statistical analysis. Eighty MICR CRC patients (colon 61%; rectal 39%; mean age 65.8 ± 13.3) were studied. The mean incision length was 8.37 ± 3.9 and mean LOS 6.5 ± 2.6 days. The cancer stage breakdown was; I (23), II (26), III (27), and IV (4). The median pre-op KGF level was 17.1 (95 %CI: 14.6-19.4; = 80); significantly elevated ( < 0.05) median levels (pg/ml) were noted on post-op day (POD) 1 (23.4 pg/ml; 95% CI: 21.4-25.9; = 80), POD 3 (22.5 pg/ml; 95% CI: 20.7-25.9; = 76), POD 7-13 (21.8 pg/ml; 95% CI: 17.7-25.4; = 50), POD 14-20 (20.1 pg/ml; 95% CI: 17.1-23.9; = 33), POD 21-27 (19.6 pg/ml; 95% CI: 15.2-24.9; = 15) and on POD 28-34 (16.7 pg/ml; 95% CI: 14.0-25.8; = 12). Plasma KGF levels were significantly elevated for 5 weeks after MICR for CRC. The etiology of these changes is unclear, surgical trauma related acute inflammatory response and wound healing process may play a role. These changes, may stimulate angiogenesis in residual tumor deposits after surgery.
人角质形成细胞生长因子（KGF）是一种由间充质细胞产生的成纤维细胞生长因子（FGF）家族蛋白。KGF可促进上皮细胞增殖，在伤口愈合中发挥作用，也可能支持肿瘤生长。它在一些结直肠癌（CRC）中表达。手术对KGF水平的影响尚不清楚。本研究的目的是评估CRC微创结直肠切除（MICR）术前和术后的血浆KGF水平。以确定癌症病理的微创结直肠切除手术后血浆KGF水平。对IRB批准的数据/血浆库中的CRC MICR患者（pts）进行了研究。采集/储存术前（术前）和术后（术后）血浆样本。晚期样本被捆绑成7天的时间段，并被视为单个时间点。采用酶联免疫吸附测定法（ELISA）测量KGF水平（pg/ml）（均值±标准差）。采用Wilcoxon配对检验进行统计分析。研究了80例CRC MICR患者（结肠癌61%；直肠癌39%；平均年龄65.8±13.3岁）。平均切口长度为8.37±3.9，平均住院时间为6.5±2.6天。癌症分期为：I期（23例）、II期（26例）、III期（27例）和IV期（4例）。术前KGF水平中位数为17.1（95%CI：14.6 - 19.4；n = 80）；术后第1天（POD 1）（23.4 pg/ml；95%CI：21.4 - 25.9；n = 80）、POD 3（22.5 pg/ml；95%CI：20.7 - 25.9；n = 76）、POD 7 - 13（21.8 pg/ml；95%CI：17.7 - 25.4；n = 50）、POD 14 - 20（20.1 pg/ml；95%CI：17.1 - 23.9；n = 33）、POD 21 - 27（19.6 pg/ml；95%CI：15.2 - 24.9；n = 15）和POD 28 - 34（16.7 pg/ml；95%CI：14.0 - 25.8；n = 12）时的中位数水平显著升高（P < 0.05）。CRC的MICR术后5周血浆KGF水平显著升高。这些变化的病因尚不清楚，手术创伤相关的急性炎症反应和伤口愈合过程可能起作用。这些变化可能会刺激术后残留肿瘤灶中的血管生成。
