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Impaired neutrophil bactericidal activity correlates with the infection occurring after surgery for esophageal cancer
T Saito1, Y Shigemitsu, T Kinoshita
1First Department of Surgery, Oita Medical University, Japan.
Abstract:
We examined whether or not preoperative impaired bactericidal activities of polymorphonuclear neutrophils (PMN) are associated with infections following surgery for esophageal cancer. Intracellular killing (KI), superoxide anion-producing capacity (SOP), and myeloperoxidase (MPO) activity were measured in 22 patients with esophageal cancer, 27 with gastric cancer, and 13 age-matched controls. The average level of KI was significantly depressed in patients with esophageal cancer or with gastric cancer, to a similar extent, compared to findings in controls, but SOP was not. In esophageal cancer patients, the SOP level was significantly higher in those with postoperative septic complications than in those without such problems, whereas the KI level was depressed to a similar extent in both. Therefore, a depression of KI with elevation of SOP of PMN may serve to predict complications of infection following surgery in patients with esophageal cancer.
Insights
Preoperative impaired intracellular killing (KI) in polymorphonuclear neutrophils (PMN) may predict postoperative infections in esophageal cancer patients. Elevated superoxide anion production (SOP) alongside depressed KI suggests increased infection risk.
Area of Science:
- Immunology
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Postoperative infections are a significant complication following major surgeries, particularly for gastrointestinal cancers.
- Polymorphonuclear neutrophils (PMN) play a critical role in the innate immune response against surgical site infections.
- Assessing preoperative immune function may offer predictive value for postoperative complications.
Purpose of the Study:
- To investigate the association between preoperative immune cell function, specifically polymorphonuclear neutrophils (PMN), and the incidence of postoperative infections in patients undergoing surgery for esophageal cancer.
- To compare the bactericidal activities of PMN in patients with esophageal cancer, gastric cancer, and healthy controls.
Main Methods:
- Measurement of intracellular killing (KI), superoxide anion-producing capacity (SOP), and myeloperoxidase (MPO) activity in PMN from 22 esophageal cancer patients, 27 gastric cancer patients, and 13 age-matched controls.
- Statistical analysis to compare immune function parameters between patient groups and controls, and to correlate these with postoperative septic complications.
Main Results:
- Patients with esophageal or gastric cancer exhibited significantly depressed average intracellular killing (KI) compared to controls.
- Superoxide anion-producing capacity (SOP) was not significantly different between cancer patients and controls overall.
- In esophageal cancer patients, higher SOP levels were observed in those who developed postoperative septic complications, while KI levels were similarly depressed in both complicated and uncomplicated cases.
Conclusions:
- A depressed intracellular killing (KI) capacity of PMN, coupled with elevated superoxide anion production (SOP), may serve as a predictive marker for postoperative infectious complications in patients undergoing surgery for esophageal cancer.
- These findings highlight the potential of preoperative immune profiling to identify high-risk patients and guide prophylactic strategies.