TLR4和PTX3及SOCS1对胃癌术后肺部感染的预测价值

Values of TLR4, PTX3 and SOCS1 in prediction of postoperative pulmonary infection in gastric cancer patients

    摘要
  • 摘要:
    目的 观察胃癌术后肺部感染患者机体Toll样受体4(TLR4)、正五聚蛋白3(PTX3)及细胞信号传导抑制因子1(SOCS1)水平变化，并分析这三种因子对术后肺部感染的预测价值，以期为胃癌术后肺部感染的临床防治提供新的思路和方法。
    方法 纳入2022年2月-2024年2月浙江大学医学院附属金华医院收治的胃癌患者80例，通过检测患者术后TLR4、PTX3、SOCS1，分析其水平变化与肺部感染的关联性。
    结果 80例胃癌患者术后发生肺部感染19例，感染率为23.75%，样本送检后共分离病原菌32株，其中革兰阴性菌20株，占比62.50%，革兰阳性菌11株，占比34.38%，真菌1株，占比3.12%；胃癌术后肺部感染患者TLR4、PTX3水平高于非感染患者(P < 0.05)，而SOCS1水平低于非感染患者(P < 0.05)；单因素分析发现年龄、手术类型及合并糖尿病在感染与非感染患者中比较存在明显差异(P < 0.05)；logistic回归分析发现年龄、合并糖尿病及TLR4、PTX3升高是影响胃癌术后肺部感染的危险因素(P < 0.05)，而SOCS1升高是影响胃癌术后肺部感染的保护因素(P < 0.05)；受试者工作特征(ROC)曲线结果显示：TLR4、PTX3、SOCS1水平评估胃癌术后肺部感染的曲线下面积(AUC)分别为0.788、0.758、0.771，且三项联合评估的AUC为0.904，敏感度、特异性分别为89.54%、80.29%。
    结论 胃癌术后肺部感染患者机体TLR4、PTX3、SOCS1水平异常变化，与肺部感染密切相关，且具有较高的评估价值。

     

    Abstract:
    OBJECTIVE To observe the changes of Toll-like receptor 4 (TLR4), pentraxin3 (PTX3) and suppressor of cytokine signaling (SOCS1) levels and to analyze their correlations with postoperative pulmonary infection in gastric cancer patients, so as to provide new ideas and methods for the clinical prevention and treatment.
    METHODS Eighty patients with gastric cancer in Jinhua affiliated Hospital, School of Medicine, Zhejiang University from Feb. 2022 to Feb. 2024 were included. TLR4, PTX3 and SOCS1 levels were tested and their associations with pulmonary infection were analyzed.
    RESULTS Postoperative pulmonary infection was found in 19 out of 80 cases with gastric cancer (23.75%). Thirty-two strains of pathogenic bacteria were isolated after sample submission, including 20 strains of gram-negative bacteria (62.50%), 11 strains of gram-positive (34.38%) and 1 strain of fungi (3.12%). The levels of TLR4 and PTX3 in gastric cancer patients with postoperative pulmonary infection were significantly higher than those in patients without infection (P < 0.05), while SOCS1 showed an opposite difference (P < 0.05). There were significant differences of age, surgical types and diabetes mellitus between infected and non-infected patients by univariate analysis (P < 0.05). Logistic regression analysis revealed that age, diabetes mellitus and increased TLR4 and PTX3 were risk factors for postoperative pulmonary infection (P < 0.05), while increased SOCS1 was a protective factor (P < 0.05). Receiver operating characteristic (ROC) curves showed that the area under curve (AUC) of TLR4, PTX3 and SOCS1 in evaluating pulmonary infection after the surgery of gastric cancer were 0.788, 0.758 and 0.771, respectively; while the AUC, sensitivity and specificity of the three indicators combined were 0.904, 89.54% and 80.29%, respectively.
    CONCLUSION The abnormal changes of TLR4, PTX3 and SOCS1 are closely related to postoperative pulmonary infection for gastric cancer patients and have high assessing values.

     

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