Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden;
Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden.
Anticancer Res. 2022 Jun;42(6):2827-2833. doi: 10.21873/anticanres.15764.
Anastomotic leakage is the most serious and unwelcome complication in rectal surgery. It has a great impact on postoperative morbidity and mortality. In this pilot study, changes of mRNA expression in blood were analyzed in an animal model designed to imitate anastomotic leakage.
Twelve pigs were randomized into two groups: A sham-operated control group and an experimental group in which iatrogenic rectal perforation was performed. The changes in the mRNA expression at 4 hours after creating the perforation were studied. Microarray analysis was performed using Gene Chip whole porcine genome array. mRNA expression of 19,124 genes was investigated.
Significantly increased levels of genes with a fold change greater than 2 were found, including 276 coding for unknown proteins and 48 coding for known proteins. Eleven of those which coded for known proteins were up-regulated with a fold change >4.
Eleven known genes were highly up-regulated after rectal perforation. These genes were mainly involved in inflammatory response, intracellular signaling and cell membrane regulation. Their corresponding proteins might potentially be clinical biomarkers of anastomotic leakage and should be evaluated in further clinical studies.
吻合口漏是直肠手术后最严重和最不受欢迎的并发症。它对术后发病率和死亡率有很大影响。在这项初步研究中，我们分析了设计用来模拟吻合口漏的动物模型中血液中 mRNA 表达的变化。
将 12 头猪随机分为两组：假手术对照组和进行医源性直肠穿孔的实验组。研究穿孔后 4 小时 mRNA 表达的变化。使用 Gene Chip 全猪基因组芯片进行微阵列分析。共研究了 19124 个基因的 mRNA 表达。
发现倍数变化大于 2 的基因水平显著增加，包括 276 个编码未知蛋白的基因和 48 个编码已知蛋白的基因。其中 11 个编码已知蛋白的基因上调倍数大于 4。
直肠穿孔后 11 个已知基因高度上调。这些基因主要参与炎症反应、细胞内信号转导和细胞膜调节。它们相应的蛋白可能是吻合口漏的潜在临床生物标志物，应在进一步的临床研究中进行评估。
