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Hungarian perioperative selenium survey in patients with oesophageal cancer

Introduction

Selenium is one of the most investigated trace elements and an important link in the antioxidant system [1]. It is known that selenium levels are lower than normal at the time of admittance to the ICU in critically ill patients [2]. Several cohort surveys highlight the role of selenium deficiency in the carcinogenesis of oesophageal cancer [3]. Mortality and morbidity data after oesophagectomy may vary, but remain considerably high [4].

Methods

In three Hungarian university centres, 36 patients who were operated on with oesophageal cancer (OG-group) and admitted to the ICU, and 96 healthy volunteers (C-group) were recruited. In the OG-group, full blood selenium levels were measured preoperatively (t0) and on the first (t1) and second (t2) postoperative days. Selenium levels were measured by atomic absorption spectrometry in the laboratories of Byosin Arzneimittel GmbH (Fellbach, Germany), blinded to patient's condition or group assignment. All data are presented as the mean ± SD. To test the normal distribution the Kolgomorov–Smirnov test was used. For statistical analysis the independent-samples t test and ANOVA were used as appropriate. For statistical analysis the Statistical Program for Social Sciences (SPSS® version 15.0) software for Windows was used. Statistical significance was considered at P < 0.05.

Results

There was a significant difference in the full blood selenium levels between the controls and preoperative samples (t0) of the OG-group (123.86 ± 19.14 μg/l vs. 98.36 ± 19.02 μg/l; P < 0.001). In the OG-group selenium levels decreased significantly during the study period; t0, 98.36 ± 19.02 μg/l; t1, 86.92 ± 17.04 μg/l; t2, 81.44 ± 18.31 μg/l; P = 0.001.

Conclusion

This study has shown significantly lower selenium levels in OG-patients as compared with controls and a significant decrease in the postoperative period. Whether this has any influence on outcome requires further investigation.

References

  1. 1.

    Papp LV, et al.: From selenium to selenoproteins: synthesis, identity, and their role in human health. Antioxid Redox Signal 2007, 9: 775-806. 10.1089/ars.2007.1528

  2. 2.

    Forceville X, et al.: Selenium, systemic immune response syndrome, sepsis, and outcome in critically ill patients. Crit Care Med 1998, 26: 1536-1544. 10.1097/00003246-199809000-00021

  3. 3.

    Lu H, et al.: Dietary mineral and trace element intake and squamous cell carcinoma of the esophagus in a Chinese population. Nutr Cancer 2006, 55: 63-70. 10.1207/s15327914nc5501_8

  4. 4.

    Rodgers M, et al.: Case volume as a predictor of inpatient mortality after esophagectomy. Arch Surg 2007, 142: 829-839. 10.1001/archsurg.142.9.829

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Leiner, T., Mikor, A., Csomos, A. et al. Hungarian perioperative selenium survey in patients with oesophageal cancer. Crit Care 13, P148 (2009). https://doi.org/10.1186/cc7312

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Keywords

  • Selenium
  • Atomic Absorption Spectrometry
  • Absorption Spectrometry
  • Antioxidant System
  • Smirnov Test