Relationship between secretory leukocyte protease inhibitor levels in bronchoalveolar lavage fluid and postoperative pulmonary complications in patients with esophageal cancer.
BACKGROUND
We investigated whether secretory leukocyte protease inhibitor (SLPI) is associated with pulmonary complications after esophagectomy.


METHODS
We measured serial changes in the SLPI concentration in the bronchoalveolar lavage fluid (BALF) of 34 patients who underwent and examined the relationship between SLPI and postoperative morbidity.


RESULTS
Fifteen (44%) of 34 patients (high group) had a BALF SLPI concentration >90,000 pg/mL at the end of the surgery (postoperative day [POD] 0). There was no significant difference between the high group and other 19 patients (low group) with respect to age, sex, preoperative comorbid conditions, tumor stage, surgical technique, operating time, or blood loss volume. Days of intubation and pulmonary complication rate were significantly increased in the high group compared with the low group. Logistic regression analysis revealed that the BALF SLPI level on POD 0 was significant for pulmonary complications.


CONCLUSIONS
Our results indicate that assaying SLPI levels in BALF can be useful for the prediction of pulmonary complications after esophagectomy.
Tsukada
Katsuhiko
K
Department of General Surgical Science (Surgery I), Graduate School of Medicine, Gunma University, 3-39-22 Showamachi Maebashi 371-8511, Japan. katukada@topaz.ocn.ne.jp
Miyazaki
Tatsuya
T
Katoh
Hiroyuki
H
Masuda
Norihiro
N
Ojima
Hitoshi
H
Fukuchi
Minoru
M
Manda
Ryokuhei
R
Fukai
Yasuyuki
Y
Nakajima
Masanobu
M
Sohda
Makoto
M
Kuwano
Hiroyuki
H
D015415:Biomarkers / Q000032:analysis; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis*; D011336:Probability; D011379:Prognosis; D053491:Proteinase Inhibitory Proteins, Secretory; D011506:Proteins / Q000032:analysis / Q000378:metabolism*; D018570:Risk Assessment; D053481:Secretory Leukocyte Peptidase Inhibitor; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome
D015415:Biomarkers; D053491:Proteinase Inhibitory Proteins, Secretory; D011506:Proteins; C506814:SLPI protein, human; D053481:Secretory Leukocyte Peptidase Inhibitor