The relationship between the levels of plasma cytokine procalcitonin, C-reactive protein and tumor necrosis factor-alpha with postoperative intestinal obstruction in patients with colorectal cancer after operation

Abstract

Objective To investigate the relationship between plasma levels of procalcitonin(PCT), C-reactive protein(CRP) and tumor necrosis factor-alpha(TNF-α) and postoperative intestinal obstruction in patients with colorectal cancer. Methods From December 2014 to December 2017, 60 patients with colorectal cancer and 60 patients who had no intestinal obstruction after operation in the Third Hospital of Shanxi Datong Coal Mine Group Limited Company were selected.The patients were divided into intestinal obstruction group and non-intestinal obstruction group.All the patients received blood examination, and the levels of PCT, CRP and TNF-α were measured.The levels of PCT, CRP and TNF-α were compared between the obstruction group and the non-intestinal obstruction group before operation, 1 day after operation and 5 days after operation.The levels of PCT, CRP and TNF-α in patients with intestinal obstruction were compared at different time points after operation.According to the outcome on the 5th day after operation, the patients in the intestinal obstruction group were divided into effective group and ineffective group, and the levels of PCT, CRP and TNF-α were compared between the effective group and the ineffective group.Pearson correlation analysis was used to analyze the correlation between the levels of PCT, CRP and TNF-α with postoperative intestinal obstruction in patients with colorectal cancer. Results At preoperative 1d and postoperative 1d, the PCT, CRP and TNF-α levels between the intestinal obstruction group and non-intestinal obstruction group had no statistically significant differences(preoperation t=0.706, 0.459, 0.249, postoperative 1 day t=0.874, 0.434, 1.460, all P>0.05). At 5 days after surgery, the levels of PCT[(1.89±0.53)ng/mL], CRP[(10.06±2.50)mg/L], TNF-α[(1.95±0.59)ng/L]in the intestinal obstruction group were higher than those in the non-intestinal obstruction group[(1.05±0.32)ng/mL, (7.27±2.06)mg/L, (1.15±0.28)ng/L, t=10.510, 6.671, 9.489, all P<0.05]. The levels of PCT, CRP and TNF-α at the fifth day after intestinal obstruction were higher than those at the first day after operation (t=12.762, 6.708, 6.973, all P<0.05). The levels of PCT[(2.13±0.48)ng/mL], CRP[(11.24±2.37)mg/L], TNF-α[(2.16±0.40)ng/L] of the ineffective group were higher than those of the effective group[(1.64±0.31)ng/mL, (8.86±1.65)mg/L, (1.77±0.32)ng/L, t=4.757, 4.507, 4.052, all P<0.05]. Correlation analysis showed that PCT, CRP and TNF-α levels were closely related to postoperative intestinal obstruction in colorectal cancer patients, and all of them were positively correlated(r=0.892, 0.817, 0.835, all P<0.05). Conclusion The levels of PCT, CRP and TNF-α in the patients with postoperative intestinal obstruction of colorectal cancer are higher than those of the control group.It can predict the occurrence of postoperative intestinal obstruction of colorectal cancer and can be used as a reference index for diagnosis and treatment of postoperative intestinal obstruction in colorectal cancer. Key words: Colorectal neoplasms; Colorectal surgery; Postoperative complications; Intestinal obstruction; Inflammation mediators; Procalcitonin; C-Reactive protein; Tumor necrosis factor-alpha