The influence of surgical treatment and red blood cell transfusion on changes in antioxidative and immune system parameters in colorectal cancer patients.

OBJECTIVE. To determine the effect of surgical treatment and red blood cell transfusion on the parameters of antioxidative and immune systems in patients with early and advanced stage colorectal cancer. MATERIAL AND METHODS. A total of 65 patients with colorectal cancer were included in the study. Three blood serum samples of each patient were tested comparing presurgical and postsurgical periods of 7 and 14 days. Malondialdehyde and total glutathione levels, activity of catalase and glutathione S-transferase were determined spectrophotometrically. The concentration of cytokines TGF-beta1 and TNF-alpha were determined by ELISA. RESULTS. Malondialdehyde and glutathione levels decreased in surgically treated patients with cancer of both stages while catalase activity decreased in patients with stage III cancer. Cytokine levels did not change after surgery. A decrease in malondialdehyde concentration was observed in the transfused patients with early stage cancer comparing postsurgical periods. Catalase activity was increased after surgery in patients with early stage cancer but was decreased during postsurgical periods in patients with advanced stage cancer. Cytokine levels increased at postsurgical periods in transfused patients with stage III cancer. Correlation between catalase activity and TNF-alpha level and between glutathione S-transferase activity and TGF-beta1 level was determined postsurgically in transfused patients with early stage cancer. CONCLUSIONS. Postsurgical period affected antioxidative system of patients with cancer of both stages while level of cytokines showed no differences. Transfusion determined distinct dynamics of antioxidative parameters due to cancer stage. Elevated cytokine levels in transfused patients with advanced stage cancer showed that the status of immune system was exacerbated. Antioxidative and immune systems were depressed in these patients. Correlation between antioxidative system parameters and cytokines in transfused patients of early stage cancer showed a relationship between two protective systems of the organism against malignant process.