Evaluation of the dynamics and level of sCD14-ST in the development of adverse outcomes in operated colorectal cancer patients

Objective: Evaluation of the dynamics and level of sCD14-ST in blood serum in the development of SIRS, infectious and inflammatory complications, organ dysfunction and mortality in patients operated on for colorectal cancer (CRC), as well as for acute bowel obstruction (ABO) of tumor and non-tumor genesis.
Materials and methods: The study involved 120 patients: group 1 - 50 patients with CRC without ABO; group 2 - 40 patients with tumor ABO; group 3 - 30 patients with non-tumor ABO. sCD14-ST was determined in blood serum by enzyme immunoassay one hour before surgery and 72 hours after it.
Results and discussion: In patients with CRC, the level of sCD14-ST on the 3rd day after surgery was 2.4 times higher in deceased patients (Z= -2.630, p=0.009), and in patients with organ dysfunctions, an increase in the level of sCD14-ST by 30% in dynamics was observed, while in patients without them sCD14-ST decreased by 18% (Z=-2.468, p=0.014). If the value of sCD14-ST on day 3 after surgery is >520 pg/mL, the risk of death is 12.3 times higher (OR 12.3, CI 2.34-64.20). With an increase in the level of sCD14-ST in dynamics from the baseline or its decrease by no more than 8.8 pg/mL, the risk of organ dysfunctions is 6.5 times higher than with its greater decrease (OR 6.5, CI 1.66-25, 83).
Conclusion: Significantly worse outcomes and prognosis were observed in CRC patients with higher levels of sCD14-ST on day 3 after surgery.

1. Assimakopoulos S. F., Triantos C., Thomopoulos K., Fligou F., Maroulis I., et al. Gut-origin sepsis in the critically ill patient: pathophysiology and treatment // Infection. – 2018. – Vol.46(6). – P.751-760.

2. Gore R.M., Silvers R.I., Thakrar K.H., et al. Bowel obstruction // Radiol Clin N Am. – 2015. – Vol.53(6). – P.1225–1240.

3. Giunco S., Petrara M.R., Bergamo F., Del Bianco P., Zanchetta M., Carmona F., et al. Immune senescence and immune activation in elderly colorectal cancer patients // Aging (Albany NY). – 2019. – Vol.11. – P.3864-3875.

4. Juroš G.F., Nikić M.T., Šarić S.D., Perić M., Rogić D. Contribution of presepsin, procalcitonin and C-reactive protein to the SOFA score in early sepsis diagnosis in emergency abdominal surgical patients // Signa Vitae. – 2019. -Vol.15. – P.38-45.

5. Liu B, Chen YX, Yin Q, Zhao YZ, Li CS. Diagnostic value and prognostic evaluation of presepsin for sepsis in an emergency department // Crit Care. – 2013. – Vol.7. – R244.

6. Pisano M., Zorcolo L., Merli C. et al. 2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation // World Journal of Emergency Surgery. – 2018. – Vol. 13(1). – P. 36-37.

7. Pokazateli onkologicheskoj sluzhby Respubliki Kazahstan za 2020 god: statisticheskie i analiticheskie materialy / pod red. D.R. Kajdarovoj, Z.D. Dushimova, O.V. SHatkovskaya i dr. – Almaty: AO «KazNIIOiR», 2021. – 366 s. [Показатели онкологической службы Республики Казахстан за 2020 год: статистические и аналитические материалы / под ред. Д.Р. Кайдаровой, З.Д. Душимова, О.В. Шатковская и др. – Алматы: АО «КазНИИОиР», 2021. – 366 с. ].

8. Scheepers J.G., Sietses C., Bos D.G., et al. Immunological consequences of laparoscopic versus open transhiatal resection for malignancies of the distal esophagus and gastroesophageal junction // Digestive Surgery. – 2008. – Vol.25. – P.140-147.

9. Takahashi, G., Shibata, S., Ishikura, H., Miura, M., Fukui, Y., Inoue, Y., Endo, S. Presepsin in the prognosis of infectious diseases and diagnosis of infectious disseminated intravascular coagulation // European Journal of Anaesthesiology. – 2-15. – Vol.32(3). – P.199–206.

10. Yaegashi Y., Shirakawa K., Sato N., et al. Evaluation of a newly identified soluble CD14 subtype as a marker for sepsis // Journal of infection and chemotherapy. – 2005. – Vol.11(5). – P.234-238.