International Journal of Hematology and Oncology 2019, Vol 29, Num 3 Page(s): 141-151
THE EFFECTS OF ADJUVANT 5-FU CHEMOTHERAPY COMBINED WITH LIVER RESECTION ON ICAM-1 EXPRESSION AND INTESTINAL BACTERIAL TRANSLOCATION

AYDIN DALGİÇ1, ATİLLA ENGİN1, İBRAHİM H. GÜLLÜ1, JEFFREY COOPER1, AYLAR POYRAZ1, GÜLEN AKYOL1, GÜLTEN TEKUZMAN1

Gazi Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı

Keywords: liver resection, 5-fluoro uracil, intestinal bacterial translocation, icam-1
Septic complications, which cause 30% morbidity and 7% mortality, is one of the main problems occurring in early postoperative period secondary to liver resection. The relationship between liver resection and intestinal bacterial translocation has been documented. The aim of the study is to analyze whether there is any relationship between, decreased detoxification capacity of liver, secondary to resection, and septic complications and Interceliular Adesion Molecule-1 (ICAM-1) expression and whether adjuvant 5-FU chemotherapy increases the risk of sepsis in two groups of rats which has been performed liver resection. Method: 200+/-50g, 40 albino wistar rats were divided into four groups (ten rats for each group). The first and second groups underwent Sham operation, third and fourth groups underwent %70 hepatic resection. The 1st and 3rd groups have been given 0.9% NaCl, the 2nd and 4th groups have been given 5-FU treatment. After five days treatment, the rats were sacrificed. Bacteriological (mesenteric lymph node (MLN) and blood culture), immunohistochemical analyses were performed for bacterial growth and ICAM-1 expression in the liver and small bowel. Results: The major intestinal mucosal ICAM-1 expression and the major bacterial translocation were observed in the 3rd and 4th groups. The major ICAM-1 expression in liver tissue was observed in the 4th group which underwent hepatic resection and 5-FU treatment. Conclusion: Decreased detoxification capacity of liver because of hepatic resection may cause insufficient metabolism of 5-FU which has toxic effect on the liver and intestinal mucosa. Mucosal toxicity of 5-FU and cytokin release secondary to liver resection may cause expression of ICAM-1 molecule in intestinal mucosa. Expression of adhesion molecules, in mucosal endothel may starts inflammation of intestinal mucosa and IBT.