Mac-1 Expression and Superoxide Generation of the Peripheral Polymorphonuclear Leukocyte following Gastrectomy and Esophagectomy

The aim of this study was to evaluate the characteristics of the polymorphonuclear leukocyte (PMN) function after surgical stress. We investigated Mac-1 expression and superoxide generation by peripheral PMNs and serum granulocyte-colony stimulating factor (G-CSF) concentrations in 15 patients who underwent either gastrectomy (n=8) or esophagectomy (n=7). The serum G-CSF rapidly increased within 24 hours after operation. The maximum levels of serum G-CSF in the cases of esophagectomy were about 5-8 fold those of gastrectomy, although the increases in PMN counts within 24 hours of esophagectomy were lower than those after gastrectomy. Mac-1 expression and superoxide generation by PMN s after gastrectomy increased significantly, in parallel with increases in the PMN counts and serum G-CSF. After esophagectomy, Mac-1 expression on peripheral PMN s remained elevated through the 7th day after operation, while superoxide generation by PMN s in response to PMA declined to below preoperative levels after the 3rd day. These results suggest that, after major surgery such as esophagectomy, there is a discrepancy between Mac-1 expression and superoxide generation by the peripheral PMN despite a high level of serum G-CSF.