Objective To explore the value of proprotein convertase subtilisin/kexin type 9 (PCSK9) as a predictor of early infectious status after endoscopic submucosal dissection (ESD) for esophageal neoplasm.
Methods A total of 65 patients who had undergone esophageal ESD for superficial neoplasm in Zhongshan Hospital, Fudan University from March to October 2017 were enrolled. Their body temperature (BT) was monitored and post-ESD fever was defined as BT ≥ 37.5℃. Blood culture was taken in the patients who had BT ≥ 38℃. An investigation was made of PCSK9, lipopolysaccharide (LPS) and other markers such as white blood cell (WBC), C-reaction protein (CRP) and interlukin-6 (IL-6).
Results It was found that 37/65 patients developed a fever, and 12/37 received blood culture, with one showing a positive result. Serum PCSK9, LPS, WBC, CRP and IL-6 all increased in the fever cohort; however, only PCSK9 and IL-6 increased significantly in those who had BT ≥ 38℃ when compared with those who had 37.5℃ ≤ BT < 38℃. The mean levels of PCSK9 were (355.29±56.17) ng/mL in the patients of BT ≥ 38℃, versus (304.19±60.91) ng/mL in the patients of 37.5℃ ≤ BT < 38℃ (P=0.020). A positive correlation plus a linear regression relationship was observed between the levels of serum PCSK9 and LPS in those who had BT ≥ 38℃ (r=0.720; P=0.011).
Conclusions PCSK9 could serve as an early and sensitive biomarker in detecting the infectious status of a patient during the perioperative period of esophageal ESD.
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