Lipopolysaccharide-binding protein as a risk factor for development of infectious and inflammatory postsurgical complications in colorectal cancer paients.

Abstract

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.