Elevated circulating dipeptidyl peptidase 3 (cDPP3) as a predictor of postoperative complications in esophagectomy patients

PURPOSE: Esophagectomy for esophageal cancer carries high postoperative morbidity and mortality. Circulating dipeptidyl peptidase 3 (cDPP3) is a novel biomarker linked to organ failure in acute care. This study evaluates its prognostic value for predicting organ dysfunction and mortality post-esophagectomy. METHODS: This prospective, single-center study included 20 esophagectomy patients. cDPP3 levels were measured preoperatively and at 24, 72, 120, and 168 h postoperatively using a Nexus IB10 Analyzer. Postoperative complications, including pneumonia, anastomotic insufficiency, and SOFA score-based organ dysfunction, were recorded. Correlation analysis assessed associations between cDPP3 levels and clinical outcomes. RESULTS: Among 20 patients, the most common complications were pneumonia (n = 12), sepsis (n = 17), and anastomotic insufficiency (n = 5). Elevated cDPP3 levels correlated with SOFA score increases ≥ 2 (p < 0.01) and severe complications, including prolonged ICU stays. cDPP3 levels at 72 h were significantly associated with anastomotic insufficiency (p < 0.01). A negative correlation was observed between intraoperative volume and cDPP3 levels at 24 h (r = -0.495, p = 0.03). CONCLUSIONS: cDPP3 is a potential biomarker for postoperative complications after esophagectomy. Its elevation correlates with increased morbidity, highlighting the need for vigilant perioperative management.