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Lysophosphatidylcholine as a predictor of postoperative complications after colorectal cancer surgery

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Abstract

Purpose

Lysophosphatidylcholine (LPC), which is generated from phosphatidylcholine (PC) and metabolized by autotaxin (ATX), modulates immune responses via its anti-inflammatory property. We investigated the association between LPC and postoperative complications (POCs) after colorectal cancer surgery (CRC).

Methods

The subjects of this study were 43 patients who underwent surgery for CRC. Peripheral blood samples were collected preoperatively and immediately after surgery, and on postoperative days (PODs) 1, 3, 5, and 7. Patients were divided into a No-POC group (n = 33) and a POC group (n = 10). Blood LPC, IL-6, PC, and ATX levels were measured by specific enzymatic assays or ELISA.

Results

The postoperative to preoperative LPC ratios were lowest on POD 1 in both groups. The POC group had significantly lower LPC ratios throughout the perioperative period than the No-POC group. The LPC ratios were inversely correlated with IL-6. The predictive impact of LPC ratios on POCs was demonstrated by ROC analysis (cut-off 51.2%, AUC 0.798) and multivariate analysis (OR 15.1, P = 0.01). The postoperative PC ratios decreased more after surgery in the POC group. ATX levels did not change significantly in either group.

Conclusions

Decreased postoperative LPC is associated with increased postoperative inflammatory response and POCs. The decreased PC supply to the circulation is a mechanism of the postoperative LPC decrease.

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Acknowledgements

This study was supported financially by a Grant-in-Aid for Scientific Research from The Ministry of Education, Culture, Sports, Science and Technology of Japan (15K10037: Matsuda A).

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Authors and Affiliations

  1. Department of Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan

    Akihisa Matsuda, Marina Yamada, Satoshi Matsumoto, Nobuyuki Sakurazawa & Masao Miyashita

  2. Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan

    Takeshi Yamada, Takeshi Matsutani & Eiji Uchida

Authors
  1. Akihisa Matsuda
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  2. Marina Yamada
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  3. Satoshi Matsumoto
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  4. Nobuyuki Sakurazawa
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Contributions

All authors are in agreement with the content of the manuscript. Authors’ contributions are as follows: study concept and design, AM and MY; acquisition of data, AM and NS; analysis and interpretation of data, AM, MY, SM, TY and TM; drafting of the manuscript, AM; study supervision, MM and EU.

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Correspondence to Akihisa Matsuda.

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We have no conflicts of interest or financial ties to disclose.

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Matsuda, A., Yamada, M., Matsumoto, S. et al. Lysophosphatidylcholine as a predictor of postoperative complications after colorectal cancer surgery. Surg Today 48, 936–943 (2018). https://doi.org/10.1007/s00595-018-1675-2

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  • DOI: https://doi.org/10.1007/s00595-018-1675-2

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