Kinetics of inflammatory markers following cancer-related bowel and liver resection

Abstract

BackgroundMacrophage migration inhibitory factor (MIF) was originally described as a cytokine that inhibits migration of macrophages at the site of inflammation. Subsequently it was also identified as a stress-induced hormone released from the anterior pituitary lobe in response to some pro-inflammatory stimuli like endotoxins and tumour necrosis factor (TNF-α).AimTo compare postoperative changes in serum MIF levels of patients undergoing bowel and liver resections. It has clinical relevance to describe the kinetics of this crucial mediator of systemic inflammation in surgery.MethodsA total of 58 patients were studied over 4 years. Group A (28 patients) underwent only hepatic resection without enterotomy. Group B (30 patients) had bowel resection with enterotomy. MIF, IL-1β, IL-8, prealbumin, albumin, α1-glycoprotein, fibrinogen, and C-reactive protein levels were measured preoperatively, immediately following surgery, and postoperatively for three consecutive days. To evaluate organ functions, multiple organ dysfunction score was used.ResultsA significantly higher level of MIF (4,505 pg/mL) was found in group A when compared to that of group B immediately following surgery. Other parameters monitored in this study were not statistically different between the two groups.ConclusionHigher elevations in MIF levels with liver resections, compared to bowel resections, might be attributable to MIF release from damaged liver cells. The presumably minimal endotoxin exposure during bowel surgery was either insufficient or inefficient to induce relevant MIF elevations in our patients. To fully delineate implications of this finding further studies are needed.

Geriatric nutritional risk index predicts prognosis in hepatocellular carcinoma after hepatectomy: a propensity score matching analysis

“…Inflammation, malnutrition, and cancer have a close relationship with each other. Malnutrition causes the deterioration of tumor immunity, leading to postoperative complications and cancer progression 3 , 4 . Furthermore, cancer-related systemic inflammation induces catabolism of patients, which causes metastasis 5 , 6 .…”

Evolución de los niveles séricos de proteína C-reactiva y procalcitonina tras resección hepática

“…Por ello, se puede considerar que en los pacientes incluidos en el estudio la producción de PCR y PCT está directamente relacionada con la intervención quirúrgica, sin la interferencia de las complicaciones posoperatorias. En nuestro estudio se observó que tanto la PCR como la PCT se elevan en todos los pacientes tras la resección hepática, independientemente del tipo de resección realizada, en consonancia con los datos publicados por otros autores [14][15][16][17] . La máxima concentración se alcanza a las 48 h de la cirugía, tanto para la PCR como para la PCT, con una mediana de 13,7 mg/dl y 0,7 ng/ml, respectivamente, y después se produce un progresivo descenso, sin que lleguen a restablecerse los valores preoperatorios durante el periodo de tiempo estudiado.…”

“…Por otra parte, Marton y cols. 16 , encontraron que la PCT alcanzaba su máximo valor a las 24 h de la cirugía, antes que lo observado en nuestro estudio, pero hay que tener en cuenta que los valores correspondientes a las 24 y 48 h fueron muy similares. A la luz de estos resultados, parece que la máxima concentración de PCR y PCT se alcanza entre las 48 y las 72 h de posoperatorio.…”

Graft‐derived macrophage migration inhibitory factor correlates with hepatocellular injury in patients undergoing liver transplantation

“…Márton et al. reported elevated serum MIF concentrations in patients after hepatic resection and suggested that the elevation of serum MIF was caused by tissue damage‐related release of MIF from hepatocytes . Pohl et al.…”