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Monitoring of procalcitonin but not interleukin-6 is useful for the early prediction of anastomotic leakage after colorectal surgery

  • Urszula Zielińska-Borkowska EMAIL logo , Naser Dib , Wiesław Tarnowski and Tomasz Skirecki
Published/Copyright: December 8, 2016
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 55 Issue 7

Abstract

Background:

Early recognition of patients who have developed anastomotic leakage (AL) after colorectal surgery is crucial for the successful treatment of this complication. The aim of this study was to assess the usefulness of the assessment of procalcitonin (PCT) and interleukin-6 (IL-6) levels in the prognosis of AL.

Methods:

This observational study included 157 patients who underwent major elective colorectal surgery. The most common indications for surgery were cancer and inflammatory bowel diseases. Serum samples were obtained directly before surgery (D0) and 1 day (D1) after surgery, and the relationships between the serum concentrations of PCT and IL-6 and development of AL were assessed.

Results:

In total, 10.2% of patients developed post-surgical infections due to AL. PCT levels on D1 were significantly higher in patients who developed AL [2.73 (1.40–4.62)] than in those who recovered without complications [0.2 (0.09–0.44)]. The area under the ROC curve for PCT on D1 was 0.94, 95% CI (0.89–0.98). The sensitivity and specificity of the prediction of an infection were 87% and 87%, respectively, for PCT on D1, which was higher than 1.09 ng/mL. The increase in PCT concentration between D0 and D1 was significantly higher in patients with AL (p<0.001). Patients who developed AL had higher concentrations of IL-6 on D1, but the difference was not significant (p=0.28).

Conclusions:

This study confirms that surgical trauma increases serum PCT concentrations and that the concentration of PCT on D1 can predict AL after colorectal surgery. However, IL-6 is not a good early marker for developing AL.

Keywords: anastomotic leakage; biomarker; interleukin-6; procalcitonin
Corresponding author: Urszula Zielińska-Borkowska, MD, PhD, Department of Anesthesiology and Intensive Care Medicine, Center of Postgraduate Medical Education, 231 Czerniakowska Street, Warsaw 00-416, Poland

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2016-8-17
Accepted: 2016-11-1
Published Online: 2016-12-8
Published in Print: 2017-6-27

©2017 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2016-0736
Keywords for this article
anastomotic leakage; biomarker; interleukin-6; procalcitonin

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. Opportunities and drawbacks of nonstandard body fluid analysis
  4. How I first met Dr. Morton K. Schwartz
  5. Reviews
  6. Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids
  7. Quality control materials for pharmacogenomic testing in the clinic
  8. Modulating thrombotic diathesis in hereditary thrombophilia and antiphospholipid antibody syndrome: a role for circulating microparticles?
  9. Opinion Papers
  10. Advances in laboratory diagnosis of hereditary spherocytosis
  11. Analytical performance specifications for external quality assessment – definitions and descriptions
  12. Genetics and Molecular Diagnostics
  13. Differences between quantification of genotype 3 hepatitis C virus RNA by Versions 1.0 and 2.0 of the COBAS AmpliPrep/COBAS TaqMan HCV Test
  14. General Clinical Chemistry and Laboratory Medicine
  15. Estimating the intra- and inter-individual imprecision of manual pipetting
  16. Effect of multiple freeze-thaw cycles on selected biochemical serum components
  17. The effect of storage temperature fluctuations on the stability of biochemical analytes in blood serum
  18. Comparison of ex vivo stability of copeptin and vasopressin
  19. Physiologic changes of urinary proteome by caffeine and excessive water intake
  20. Assessment of autoantibodies to interferon-ω in patients with autoimmune polyendocrine syndrome type 1: using a new immunoprecipitation assay
  21. Reference Values and Biological Variations
  22. Within-day biological variation and hour-to-hour reference change values for hematological parameters
  23. Relationship between anti-Müllerian hormone and antral follicle count across the menstrual cycle using the Beckman Coulter Access assay in comparison with Gen II manual assay
  24. Cardiovascular Diseases
  25. Low-grade inflammation and tryptophan-kynurenine pathway activation are associated with adverse cardiac remodeling in primary hyperparathyroidism: the EPATH trial
  26. Infectious Diseases
  27. Comparison between procalcitonin and C-reactive protein in predicting bacteremias and confounding factors: a case-control study
  28. Monitoring of procalcitonin but not interleukin-6 is useful for the early prediction of anastomotic leakage after colorectal surgery
  29. Activation of the tryptophan/serotonin pathway is associated with severity and predicts outcomes in pneumonia: results of a long-term cohort study
  30. Letters to the Editor
  31. Incidental findings of monoclonal proteins from carbohydrate-deficient transferrin analysis using capillary electrophoresis
  32. IgD-λ myeloma with extensive free light-chain excretion: a diagnostic pitfall in the identification of monoclonal gammopathies
  33. 25-Hydroxyvitamin D threshold values should be age-specific
  34. Effect of dabigatran treatment at therapeutic levels on point-of-care international normalized ratio (INR)
  35. Alkaline phosphatase activity – pH impact on the measurement result
  36. Cyst hydatid and cancer: the myth continues
  37. Role of activated platelets in severe acne scarring and adaptive immunity activation
  38. Towards a random-access LC-MS/MS model for busulfan analysis
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