Ann Coloproctol.  2022 Dec;38(6):442-448. 10.3393/ac.2022.00115.0016.

Presepsin (soluble CD14 subtype) as a risk factor for the development of infectious and inflammatory complications in operated colorectal cancer patients

Affiliations
  • 1Department of Surgical Diseases, Resuscitation and Emergency Medical Care, NJSC “Karaganda Medical University,” Karaganda, Kazakhstan
  • 2Collective Use Laboratory of the Research Center, Resuscitation and Emergency Medical Care, NJSC “Karaganda Medical University,” Karaganda, Kazakhstan
  • 3Department of Anesthesiology, Resuscitation and Emergency Medical Care, NJSC “Karaganda Medical University,” Karaganda, Kazakhstan
  • 4Laboratory of National Research Institute of Antimicrobial Chemotherapy, Smolensk State Medical University, Smolensk, Russia

Abstract

Purpose
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.
Methods
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.
Results
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).
Conclusion
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.

Keyword

sCD14-ST; Colorectal neoplasms; Intestinal obstruction; Systemic inflammatory response syndrome; Complications
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