Antibody response correlates with septic complications following esophagectomy for cancer

Correlations between preoperative antibody response and postoperative septic complications were examined in patients with esophageal cancer. Thirty-three patients and 9 age-matched controls were immunized with 23-valent pneumococcal polysaccharide (PPS) vaccine, and serum anti-PPS IgG, IgA, and IgM were measured. Of 28 patients undergoing transthoracic esophagectomy, 9 had postoperative septic complications (SCP) and 19 did not (SCN). Median titers of anti-PPS IgG-producing capacity were 158 ELISA units (EU) (interquartile range, 71-1,862 EU) in the SCP group and 1,349 EU (interquartile range, 741-2,951 EU) in the SCN group (P = 0.01). No significant differences in anti-PPS IgA and IgM were found between the two groups. These results indicated that low antibody response to polysaccharides is associated with the occurrence of postoperative septic complications in patients with esophageal cancer. Thus, a preoperative evaluation of antibody-producing capacity may serve to predict these complications.