Shakeyev Kayrat, Turgunov Yermek, Ogizbayeva Alina, Avdiyenko Olga, Mugazov Miras, Grigolashvili Sofiko, Azizov Ilya
Department of Surgical Diseases, Resuscitation and Emergency Medical Care, NJSC "Karaganda Medical University," Karaganda, Kazakhstan.
Collective Use Laboratory of the Research Center, Resuscitation and Emergency Medical Care, NJSC "Karaganda Medical University," Karaganda, Kazakhstan.
Ann Coloproctol. 2022 Dec;38(6):442-448. doi: 10.3393/ac.2022.00115.0016. Epub 2022 Apr 4.
In this pilot study the dynamic of presepsin (soluble CD14 subtype, sCD14-ST) in blood serum was assessed as a possible risk factor for the development of systemic inflammatory response syndrome (SIRS) and infectious and inflammatory complications in operated colorectal cancer patients.
To determine sCD14-ST by enzyme-linked immunosorbent assay method venous blood was taken 1 hour before surgery and 72 hours after it (3rd day). The presence of SIRS and organ dysfunctions (ODs) according to the Sequential Organ Failure Assessment scale were assessed.
Thiry-six patients with colorectal cancer were enrolled in the study. sCD14-ST level before surgery was 269.8±103.1 pg/mL (interquartile range [IQR], 196.7-327.1 pg/mL). Despite the presepsin level on the 3rd day being higher (291.1±136.5 pg/mL; IQR, 181.2-395.5 pg/mL), there was no statistical significance in its dynamics (P=0.437). sCD14-ST value both before surgery and on the 3rd day after it was significantly higher in patients with bowel obstruction (P=0.038 and P=0.007). sCD14-ST level before surgery above 330 pg/mL showed an increase in the probability of complications, SIRS, and OD (odds ratio [OR], 5.5; 95% confidence interval [CI], 1.1-28.2; OR, 7.0; 95% CI, 1.3-36.7; and OR, 13.0; 95% CI, 1.1-147.8; respectively). Patients with OD had higher levels on the 3rd day after surgery (P=0.049).
sCD14-ST level in operated colorectal cancer patients was much higher if they were admitted with complication like bowel obstruction. Higher preoperative levels of sCD14-ST increase the probability of postoperative complications, SIRS, and OD. Therefore, further studies with large sample size are needed.
在这项初步研究中,评估血清中可溶性髓系细胞触发受体-1( presepsin,可溶性CD14亚型,sCD14-ST)的动态变化,作为接受手术的结直肠癌患者发生全身炎症反应综合征(SIRS)以及感染性和炎症性并发症的可能危险因素。
采用酶联免疫吸附测定法测定sCD14-ST,于手术前1小时及术后72小时(第3天)采集静脉血。根据序贯器官衰竭评估量表评估SIRS和器官功能障碍(OD)的存在情况。
36例结直肠癌患者纳入本研究。手术前sCD14-ST水平为269.8±103.1 pg/mL(四分位间距[IQR],196.7 - 327.1 pg/mL)。尽管第3天的可溶性髓系细胞触发受体-1水平较高(291.1±136.5 pg/mL;IQR,181.2 - 395.5 pg/mL),但其动态变化无统计学意义(P = 0.437)。肠梗阻患者手术前及术后第3天的sCD14-ST值均显著更高(P = 0.038和P = 0.007)。手术前sCD14-ST水平高于330 pg/mL表明并发症、SIRS和OD的发生概率增加(优势比[OR]分别为5.5;95%置信区间[CI],1.1 - 28.2;OR为7.0;95% CI,1.3 - 36.7;以及OR为13.0;95% CI,1.1 - 147.8)。发生OD的患者术后第3天水平更高(P = 0.049)。
伴有肠梗阻等并发症入院的接受手术的结直肠癌患者,其sCD14-ST水平更高。术前较高的sCD14-ST水平会增加术后并发症、SIRS和OD的发生概率。因此,需要进行更大样本量的进一步研究。