The dynamics of the lipopolysaccharide-binding protein (LBP) level in assessing the risk of adverse outcomes in operated colorectal cancer patients.

Abstract

The main aim of this study is to analyze changes in the lipopolysaccharide-binding protein (LBP) level in blood serum over time and assess it as a potential risk factor for the development of SIRS, infectious and inflammatory complications, organ dysfunction and mortality in patients operated on colorectal cancer (CRC). 90 CRC patients were divided into 2 groups: Group 1-50 patients operated on for CRC without acute bowel obstruction (ABO); Group 2-40 patients operated on for CRC with ABO. To determine LBP by ELISA method venous blood was taken 1h before surgery and 72h after it (3rd day). LBP level on the 3rd day after surgery was lower in CRC patients with SIRS, postoperative complications, organ dysfunction and in dead patients. With an LBP value on the 3rd day after surgery being at ≤821.95ng/mL, the risk of SIRS occurrence is 3.5 times higher, that of the postoperative complications is 5.2 times higher and death is 12.9 times higher than with its higher level (OR 3.5, CI 1.46-8.4; OR 5.2, CI 1.80-15.12; OR 12.9, CI 1.54-108.21, respectively). If the LBP value on the 3rd day after surgery is≤700.15ng/mL, the risk of organ dysfunctions is 13.5 times higher than with its higher level (OR 13.5, CI 3.536-51.54). This study demonstrated that in the patients with CRC, the LBP can be used as a predictive criterion for the development of SIRS, postoperative infectious and inflammatory complications, organ dysfunction, and mortality.