{"title":"瘦素对结直肠癌术后腹膜粘连形成的影响。","authors":"Takeru Maekawa, Toru Miyake, Masatsugu Kojima, Soichiro Tani, Takashi Matsunaga, Yusuke Nishina, Sachiko Kaida, Hiromitsu Maehira, Tomoharu Shimizu, Masaji Tani","doi":"10.1007/s00384-025-04851-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative peritoneal adhesion formation (PAF) is a distressing complication. Leptin, secreted by fat tissues, may be associated with PAF. However, the relationships between PAF and leptin are unclear. This study investigated the impact of leptin on PAF after colorectal tumor resection.</p><p><strong>Methods: </strong>A cecum cauterization mouse model was used to investigate PAF and its association with leptin. Mice adhesion score (AS) was evaluated on day 7 after treatment. The clinical study included patients who underwent elective colorectal resection with temporary ileostomy between April 2021 and December 2024. The AS was evaluated at the time of ileostomy closure. Patients with the highest AS quartile were classified into the high-AS group; clinical factors associated with PAF were examined. An enzyme-linked immunosorbent assay was used to measure human and murine serum leptin concentrations.</p><p><strong>Results: </strong>The animal experiment revealed that serum leptin levels on postoperative day 7 were negatively correlated with mice ASs (P = 0.0043, r = -0.6241). In a clinical study, eight patients had a high AS (27.6%). Visceral fat mass and preoperative serum leptin levels were higher in the high-AS group than in the low-AS group. The serum leptin ratio (postoperative value to preoperative value) on postoperative day 7 was lower in the high-AS group. In multivariate analysis, the serum leptin ratio was an independent factor for classifying into the high-AS group.</p><p><strong>Conclusions: </strong>A decrease in postoperative serum leptin levels was associated with severe PAF. 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However, the relationships between PAF and leptin are unclear. This study investigated the impact of leptin on PAF after colorectal tumor resection.</p><p><strong>Methods: </strong>A cecum cauterization mouse model was used to investigate PAF and its association with leptin. Mice adhesion score (AS) was evaluated on day 7 after treatment. The clinical study included patients who underwent elective colorectal resection with temporary ileostomy between April 2021 and December 2024. The AS was evaluated at the time of ileostomy closure. Patients with the highest AS quartile were classified into the high-AS group; clinical factors associated with PAF were examined. An enzyme-linked immunosorbent assay was used to measure human and murine serum leptin concentrations.</p><p><strong>Results: </strong>The animal experiment revealed that serum leptin levels on postoperative day 7 were negatively correlated with mice ASs (P = 0.0043, r = -0.6241). In a clinical study, eight patients had a high AS (27.6%). Visceral fat mass and preoperative serum leptin levels were higher in the high-AS group than in the low-AS group. The serum leptin ratio (postoperative value to preoperative value) on postoperative day 7 was lower in the high-AS group. In multivariate analysis, the serum leptin ratio was an independent factor for classifying into the high-AS group.</p><p><strong>Conclusions: </strong>A decrease in postoperative serum leptin levels was associated with severe PAF. 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引用次数: 0
摘要
目的：术后腹膜粘连形成（PAF）是一种令人痛苦的并发症。由脂肪组织分泌的瘦素可能与PAF有关。然而，PAF和瘦素之间的关系尚不清楚。本研究探讨了瘦素对结直肠肿瘤切除术后PAF的影响。方法：采用小鼠盲肠烧灼模型研究PAF及其与瘦素的关系。治疗后第7天测定小鼠粘附评分（AS）。该临床研究包括在2021年4月至2024年12月期间接受择期结肠直肠切除术和临时回肠造口术的患者。在回肠造口闭合时评估AS。AS四分位数最高的患者分为高AS组；检查与PAF相关的临床因素。采用酶联免疫吸附法测定人和鼠血清瘦素浓度。结果：动物实验显示，术后第7天血清瘦素水平与小鼠as呈负相关（P = 0.0043, r = -0.6241）。在一项临床研究中，8例患者有高AS（27.6%）。高as组的内脏脂肪量和术前血清瘦素水平高于低as组。高as组术后第7天血清瘦素比值（术后与术前比值）较低。在多变量分析中，血清瘦素比率是判定高as组的独立因素。结论：术后血清瘦素水平降低与严重PAF有关。瘦素可能是PAF中一个新的关键分子。
Impact of leptin on postoperative peritoneal adhesion formations in colorectal resection.
Purpose: Postoperative peritoneal adhesion formation (PAF) is a distressing complication. Leptin, secreted by fat tissues, may be associated with PAF. However, the relationships between PAF and leptin are unclear. This study investigated the impact of leptin on PAF after colorectal tumor resection.
Methods: A cecum cauterization mouse model was used to investigate PAF and its association with leptin. Mice adhesion score (AS) was evaluated on day 7 after treatment. The clinical study included patients who underwent elective colorectal resection with temporary ileostomy between April 2021 and December 2024. The AS was evaluated at the time of ileostomy closure. Patients with the highest AS quartile were classified into the high-AS group; clinical factors associated with PAF were examined. An enzyme-linked immunosorbent assay was used to measure human and murine serum leptin concentrations.
Results: The animal experiment revealed that serum leptin levels on postoperative day 7 were negatively correlated with mice ASs (P = 0.0043, r = -0.6241). In a clinical study, eight patients had a high AS (27.6%). Visceral fat mass and preoperative serum leptin levels were higher in the high-AS group than in the low-AS group. The serum leptin ratio (postoperative value to preoperative value) on postoperative day 7 was lower in the high-AS group. In multivariate analysis, the serum leptin ratio was an independent factor for classifying into the high-AS group.
Conclusions: A decrease in postoperative serum leptin levels was associated with severe PAF. Leptin may be a novel key molecule in PAF.
期刊介绍：
The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies.
The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.
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