摘要
目的探讨结直肠癌术后腹腔感染对外周血抗/促肿瘤通路基因mRNA水平及预后的影响。方法选择金华市人民医院2017年3月-2019年3月进行根治性结直肠癌手术并在术后发生腹腔感染患者30例作为感染组,选择同期结直肠癌根治性手术但术后未发生腹腔感染患者30例作为未感染组。患者在入组时抽取外周血,检测血清C-反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平和S100钙结合蛋白P(S100P)、解离素金属蛋白酶9(ADAM9)、α-1-酸性糖蛋白1前体(ORM1)、X染色体凋亡抑制蛋白基因(XAF1)、鸟苷酸结合蛋白1(GBP1)、肉芽素(Granulysin,GNLY)基因在mRNA上的相对表达。结果感染患者共分离培养病原菌36株,其中革兰阴性菌25株占69.44%,革兰阳性菌11株占30.56%;感染组CRP、PCT、IL-6水平高于非感染组,CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平低于非感染组(P<0.05);感染组S100P、ADAM9、ORM1基因mRNA水平高于非感染组,而XAF1、GBP1和GNLY基因mRNA水平低于非感染组(P<0.05);Kaplan-Meier分析结果显示,截止随访终点,感染组疾病进展、复发、死亡或再次入院人数为9人,非感染组疾病进展、复发、死亡或再次入院人数为4人,两组差异有统计学意义(P<0.05)。结论结直肠癌术后腹腔感染患者全身炎性水平上调,细胞免疫功能下降,促瘤基因表达上调而抑瘤基因下调,可能是导致患者预后不良的因素之一。
OBJECTIVE To explore the effect of abdominal cavity infection on peripheral blood anti/pro-tumor pathway gene mRNA levels and prognosis after colorectal cancer surgery.METHODS Totally 30 patients with radical colorectal cancer and abdominal infection after surgery in Jinhua People′s Hospital from Mar.2017 to Mar.2019 were selected as infection group,and 30 patients with colorectal cancer radical surgery but no abdominal infection after surgery were selected as non-infection group.The peripheral blood of patients was collected at the time of admission,and the relative expression of serum C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+) levels and S100 calcium-binding protein P(S100 P),disintegrin metalloprotease 9(ADAM9),α-1-acidic glycoprotein 1 precursor(ORM1),X chromosome apoptosis inhibitory protein gene(XAF1),guanylate binding protein 1(GBP1),and Granulysin(GNLY) in mRNA was detected.RESULTS A total of 36 strains of pathogenic bacteria were isolated and cultured from infected patients,of which 25 strains of Gram-negative bacteria accounted for 69.44%,and 11 strains of Gram-positive bacteria accounted for 30.56%.The levels of CRP,PCT and IL-6 in the infection group were significantly higher than those in the non-infection group,and the levels of CD_(4)^(+) and CD_(4)^(+)/CD_(8)^(+) were significantly lower than those in the non-infection group(P<0.05).The mRNA levels of S100 P,ADAM9 and ORM1 in the infection group were significantly higher than those in the non-infection group,while the mRNA levels of XAF1,GBP1 and GNLY were significantly lower than those in the non-infection group(P<0.05).Kaplan-Meier analysis showed that by the end of the follow-up,the number of patients in the infection group with disease progression,recurrence,death or re-admission was 9,and the number of patients in the non-infection group with disease progression,recurrence,death or re-admission was 4,the difference between the two groups was significant(P<0.05).CONCLUSION Postoperative colorectal cancer patients with abdominal cavity infection had increased systemic inflammatory levels,decreased cellular immune function,increased expression of tumor-promoting genes and down-regulated tumor suppressor genes,which might be one of the factors leading to poor prognosis of patients.
作者
张继超
林恒军
邱学科
章波
朱天宇
ZHANG Ji-chao;LIN Heng-jun;QIU Xue-ke;ZHANG Bo;ZHU Tian-yu(Jinhua People′s Hospital,Jinhua,Zhejiang 321000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第20期3162-3166,共5页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生科技计划基金资助项目(2018KYB233)。
关键词
结直肠癌
腹腔感染
肿瘤基因
实时荧光定量聚合酶链式反应
预后
Colorectal cancer
Abdominal cavity infection
Tumor genes
Real-time fluorescent quantitative polymerase chain reaction
Prognosis
作者简介
张继超(1988-),男,本科,主治医师,研究方向:结直肠癌和肛周疾病。
