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首页> 外文期刊>Surgical Endoscopy >Altered plasma matrix metalloproteinase-9/tissue metalloproteinase-1 concentration during the early postoperative period in patients with colorectal cancer.
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Altered plasma matrix metalloproteinase-9/tissue metalloproteinase-1 concentration during the early postoperative period in patients with colorectal cancer.

机译：大肠癌患者术后早期血浆基质金属蛋白酶9 /组织金属蛋白酶-1的浓度改变。

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BACKGROUND: The authors have previously demonstrated that insulin-like growth factor binding protein-3 (IGFBP-3) is depleted in plasma for 1 to 3 days after major open surgery (OS), but not after laparoscopic surgery (LS). After surgery, IGFP-3 cleavage occurs rapidly and is likely attributable to altered plasma proteolytic activity. This study aimed to assess plasma proteolysis after both open and closed colorectal resection and, if possible, to identify a protease/protease inhibitor system affected by surgery. METHODS: Plasma from 88 patients with colorectal cancer (stages I-III) who underwent resection was obtained preoperatively (pre-OP) and on postoperative days (POD) 1 to 3. Plasma proteolytic activity was assessed via zymography. On the basis of the results, specific protease and protease inhibitor concentrations were next measured via enzyme-linked immunoassay (ELISA). Statistical analysis was performed using Wilcoxon's test. RESULTS: Early after surgery, zymography showed a predominant band representing a 92-kDa gelatinase corresponding to a proform of matrix metalloproteinase-9 (MMP-9), a protease known to cleave IGFBP-3. In OS patients, the mean concentration of plasma MMP-9 was significantly higher on POD 1 than at pre-OP (p < 0.003). On POD 2 and 3, no differences were noted. In the LS group, the mean levels of MMP-9 before and after surgery were comparable. The levels of a natural MMP-9 inhibitor, tissue inhibitor of metalloproteinase-1 (TIMP-1), also were measured. In the OS group, the level of TIMP-1 was significantly higher on POD 1 (p < 0.0003) and POD 2 (p < 0.01) and 3 (p < 0.01) than at pre-OP. In the LS group, a smaller but significant increase in TIMP-1 levels was found between the pre-OP sample and the POD 1 (p < 0.01) and POD 2 (p < 0.01) samples. No difference was noted on POD 3 (p = 0.1). CONCLUSIONS: Open surgery, but not laparoscopic surgery, is accompanied by a short-lived significant increase in MMP-9 levels, which likely accounts for the decrease in IGFBP-3 levels observed after OS. The transitory nature of MMP-9 imbalance may be attributable to the increase in TIMP-1 levels postoperatively.
机译：背景：作者先前已经证明，在大手术后（OS），但在腹腔镜手术（LS）后，血浆中胰岛素样生长因子结合蛋白-3（IGFBP-3）的血浆消耗量为1至3天。手术后，IGFP-3裂解迅速发生，可能归因于血浆蛋白水解活性的改变。这项研究旨在评估开放性和封闭性结直肠切除术后的血浆蛋白水解，并在可能的情况下鉴定受手术影响的蛋白酶/蛋白酶抑制剂系统。方法：从术前（术前）和术后第1至3天（POD）获得88例接受切除的大肠癌（I-III期）患者的血浆。通过酶谱评估血浆蛋白水解活性。根据结果​​，接下来通过酶联免疫测定（ELISA）测量特定蛋白酶和蛋白酶抑制剂的浓度。使用Wilcoxon检验进行统计分析。结果：术后早期，酶谱显示占主导地位的条带代表一个92 kDa的明胶酶，对应于基质金属蛋白酶9（MMP-9）的形式，基质金属蛋白酶9（一种已知可裂解IGFBP-3的蛋白酶）。在OS患者中，POD 1上血浆MMP-9的平均浓度显着高于OP前（p <0.003）。在POD 2和POD 3上，未发现差异。在LS组，手术前后MMP-9的平均水平相当。还测量了天然MMP-9抑制剂（金属蛋白酶1组织抑制剂）（TIMP-1）的水平。在OS组中，POD 1（p <0.0003），POD 2（p <0.01）和POD 2（p <0.01）上TIMP-1的水平显着高于OP前。在LS组中，在OP前样品与POD 1（p <0.01）和POD 2（p <0.01）样品之间，TIMP-1水平有较小但显着的增加。在POD 3上未发现差异（p = 0.1）。结论：开腹手术而不是腹腔镜手术伴随着MMP-9水平的短暂显着升高，这可能是OS后观察到的IGFBP-3水平降低的原因。 MMP-9不平衡的暂时性质可能归因于术后TIMP-1水平的升高。

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