Diseases of the Colon & Rectum

, Volume 47, Issue 6, pp 911–918

Depletion of Circulating Insulin-Like Growth Factor Binding Protein 3 After Open Surgery is Associated With High Interleukin-6 Levels

  • Irena Kirman
  • Natalia Poltaratskaia
  • Vesna Cekic
  • Kenneth A. Forde
  • Parswa Ansari
  • Catherine Boulay
  • Richard L. Whelan
Original Contribution
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PURPOSE:

We have previously shown that plasma from open, but not laparoscopic-assisted, surgery patients has increased mitogenic activity for colon cancer cells. Decreased insulin-like growth factor binding protein 3 levels, most likely the result of an open surgery-induced proteolytic activity, may account for this finding. Plasma proteases are activated by interleukin-6. This study was designed to investigate plasma insulin-like growth factor binding protein 3 and interleukin-6 levels after major open or laparoscopic-assisted surgery.

METHODS:

EDTA plasma was obtained from 24 patients undergoing resection for colonic adenocarcinoma. Insulin-like growth factor binding protein 3 was detected by Western blot analysis and enzyme-linked immunosorbent assay. Interleukin-6 levels were determined by enzyme-linked immunosorbent assay. The effect of insulin-like growth factor binding protein 3 on tumor growth was tested using HCT116 cells.

RESULTS:

In patients undergoing open surgery, enzyme-linked immunosorbent assay revealed a significant decrease in total insulin-like growth factor binding protein 3 levels on postoperative Day 1 (915.6 ± 378.5 ng/ml) compared with preoperative levels (1,267.5 ± 407.9 ng/ml; P < 0.001). Western blots revealed a decrease in the levels of intact insulin-like growth factor binding protein 3. In patients undergoing laparoscopic-assisted surgery, levels of total and intact insulin-like growth factor binding protein 3 before surgery (1,088.9 ± 232.5 ng/ml) and on postoperative Day 1 (1,202.3 ± 285.6 ng/ml) were comparable with no significant changes in Western blot analysis. Interleukin-6 levels were undetectable preoperatively. On postoperative Day 1, interleukin-6 concentration was higher in open surgery group (434.8 ± 506.6 pg/ml) compared with laparoscopic-assisted surgery group (100.9 ± 60.2 pg/ml; P < 0.0001), and correlated significantly with a decrease in plasma insulin-like growth factor binding protein 3 after open surgery (r = 0.81; P < 0.0001).

CONCLUSIONS:

A significant decrease in both total and free insulin-like growth factor binding protein 3 occurs after open but not laparoscopic colectomy. There is an associated increase in the levels of interleukin-6. It remains to be proven that the interleukin-6 elevations are responsible for the low insulin-like growth factor binding protein 3 level seen after open surgery.

Keywords

Colon cancer Insulin-like growth factor binding protein 3 Interleukin-6 Surgery 

Copyright information

© The American Society of Colon and Rectal Surgeons 2004

Authors and Affiliations

  • Irena Kirman
    • 1
  • Natalia Poltaratskaia
    • 1
  • Vesna Cekic
    • 1
  • Kenneth A. Forde
    • 1
  • Parswa Ansari
    • 1
  • Catherine Boulay
    • 1
  • Richard L. Whelan
    • 1
  1. 1.Department of SurgeryCollege of Physicians and Surgeons of Columbia UniversityNew York

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