Article

Group IIA-soluble phospholipase A2 levels in patients with infections after esophageal cancer surgery.

Department of Surgery 1, Iwate Medical University School of Medicine, Morioka, Japan.
Surgery Today (impact factor: 1.22). 02/2005; 35(11):912-8. DOI:10.1007/s00595-005-3059-7 pp.912-8
Source: PubMed

ABSTRACT To examine the changes in blood-soluble phospholipase A(2)-IIA levels caused by surgical stress and postoperative infections.
We retrospectively analyzed a prospective database of 40 patients who underwent esophagectomy for esophageal cancer. Nine of these patients had a postoperative infection (E Inf(+) group), and 31 did not have a postoperative infection (E Inf(-) group). The blood sPLA(2)-IIA level was measured using a radioimmunoassay, and whole blood was stimulated with lipopolysaccharide (LPS) to examine the sPLA(2)-IIA production.
In the E Inf(-) group, the blood sPLA(2)-IIA levels peaked on postoperative day (POD) 3 then decreased gradually thereafter. Receiver-operator characteristic statistics based on the sPLA(2)-IIA values on POD 5, which are used to classify postoperative infectious complications, revealed an area under the curve of 0.789. However, stimulation of peripheral blood cells with LPS did not induce the production of sPLA(2)-IIA.
During the early postoperative phase, blood sPLA(2)-IIA levels increase according to the surgical stress. Soluble PLA(2)-IIA may be produced at the site of infection or in the liver, but not in the circulating blood. Sustained elevation of the serum sPLA(2)-IIA level, observed even after POD 3, seems to represent a response to postoperative infection.

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Keywords

blood sPLA(2)-IIA level
 
blood sPLA(2)-IIA levels
 
blood sPLA(2)-IIA levels increase
 
blood-soluble phospholipase A(2)-IIA levels
 
circulating blood
 
classify postoperative infectious complications
 
esophagectomy
 
lipopolysaccharide
 
peripheral blood cells
 
POD 5
 
postoperative day
 
postoperative infection
 
postoperative infections
 
postoperative phase
 
prospective database
 
Receiver-operator characteristic statistics
 
Soluble PLA(2)-IIA
 
sPLA(2)-IIA production
 
surgical stress
 
whole blood