Bacterial translocation is the penetration of intestinal bacteria through the intestinal mucosa into usually sterile tissues and internal organs. Commensal bacteria, despite their presence in the intestine in extremely large numbers, rarely cause local or systemic inflammation, because the unicellular epithelial layer of the intestinal mucosa prevents the migration of these bacteria from the intestine. For years, researchers have wondered how a single layer of intestinal epithelial cells can prevent microorganisms from entering the systemic circulation. Today, the phenomenon of bacterial translocation is considered as one of the main mechanisms of endotoxemia and systemic inflammatory response syndrome in various pathologies, including colorectal cancer and acute bowel obstruction. This narrative review is devoted to the search for factors promoting to bacterial translocation from the intestine in colorectal cancer and acute malignant bowel obstruction.

Aim of the study: 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. Material and methods: 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.Results: 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 rd day it was 766.5 ± 159.4 ng/ml (IQR 669.5-847.6), which was a statistically significant decrease (p = 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 (p = 0.046). Conclusions: This study demonstrated that the LBP level in the operated CRC patients tends to decrease on the 3 rd 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.

Background: The main aim was to analyze dynamic changes in the level of soluble CD14 subtype (sCD14-ST) in blood serum and assess it as a possible risk factor for the development of systemic inflammatory response syndrome, infectious and inflammatory complications, organ dysfunction, and mortality in operated colorectal cancer (CRC) patients. Materials and methods: For the period 2020–2021, 90 operated CRC patients were examined. Patients were divided into two groups: 1 – 50 patients operated on for CRC without acute bowel obstruction (ABO); 2 – 40 patients operated on for tumor ABO caused by CRC. To determine sCD14-ST by the ELISA (enzyme-linked immunosorbent assay) method, venous blood was taken 1 h before surgery and 72 h after it (third day). Results: sCD14-ST levels were higher in CRC patients with ABO, organ dysfunction, and dead patients. If the sCD14-ST level on the third day after surgery is greater than 520 pg/ml, the risk of a fatal outcome is 12.3 times higher than at its lower level [odds ratio (OR): 12.3, 95% CI: 2.34–64.20]. With the increase in the sCD14-ST level on the third day after surgery from baseline or its decrease by no more than 8.8 pg/ml, the risk of organ dysfunctions is 6.5 times higher than with its greater decline (OR: 6.5, 95% CI: 1.66–25.83). Conclusions: This study has demonstrated that in CRC patients, sCD14-ST can be used as a predictive criterion for the development of organ dysfunction and death. Significantly worse results and prognosis were observed in the patients with higher levels of sCD14-ST on the third day after surgery.

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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.