Abstract
Background
Postoperative infectious complications are the leading causes for postoperative sepsis.
In severe sepsis, tumor necrosis factor-beta (TNF-β) NcoI polymorphism was associated
with increased mortality. Therefore, the aim of this study was to determine whether
the biallelic NcoI polymorphism within the TNF locus is associated with the development
of postoperative complications.
Methods
One hundred sixty patients were included in this prospective observation study. Patients
undergoing major gastrointestinal surgery, such as esophagectomy, gastrectomy, Whipple
operation, major liver resection, or colon resection were included. Patients were
monitored during the clinical course, and postoperative complications, divided into
severe and minor complications, were documented. The NcoI restriction fragment length
polymorphism of the TNF-β gene was determined by polymerase chain reaction; gene expression
as well as complications were correlated.
Results
The patients' genotype distribution and demographic characteristics were comparable
within the different groups of operations. Patients with the heterozygous genotype
TNF-β1/β2 had a 1.6-fold higher relative risk for developing complications. If patients
with the homozygous genotype TNF-β2 developed a complication, they had a 1.5-fold
higher relative risk for severe complications. Furthermore, the mortality of patients
with postoperative sepsis who were homozygous for the genotype TNF-β2 was significantly
elevated.
Conclusions
The TNF-β NcoI polymorphism influences the development of postoperative complications.
While the genotype TNF-β1/β2 has a higher risk for developing complications in general,
the TNF-β2/β2 genotype is associated with more severe complications and mortality
from sepsis.
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Article info
Publication history
Accepted:
August 10,
2003
Footnotes
☆Parts of this paper were presented at the 14th Annual Meeting of the Surgical Infection Society-Europe, Danzig, Poland, May 31–June 3, 2003, and were published as an abstract in the British Journal of Surgery 2001;88(8):1141.
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
