OBJECTIVE To investigate the expression and clinical significance of microRNA-223 (miR-223), monocyte chemoattractant protein-1 (MCP-1), and basic fibroblast growth factor (bFGF) in patients with colostomy infection after rectal cancer surgery.

METHODS One hundred patients with rectal cancer who underwent surgery in Zhejiang Provincial People ′s Hospital between Jun. 2022 and Jun. 2024 were chosen retrospectively and divided into an infection group (n=27) and a non-infection group (n=73) based on whether colostomy infection occurred within seven days after surgery. The etiological features of postoperative hospital-acquired infection were analyzed, and the differences in serum miR-223, bFGF, and MCP-1 levels between the infected and non-infected groups were detected. The receiver operating characteristic (ROC) curve was used to analyze the predictive values of serum miR-223, bFGF, and MCP-1 for postoperative colostomy infection.

RESULTS A total of 30 pathogenic strains were isolated from 27 patients in the infection group, including 17 gram-negative bacteria (56.67%), 11 gram-positive bacteria (36.67%), and 2 fungi (6.67%), with Escherichia coli being the most common. The serum levels of miR-223 and MCP-1 were higher in the infected group than those in the non-infected group, while bFGF was lower in the infected group (P < 0.05). The ROC curve analysis showed that the area under the curve (AUC) for the combined detection of serum miR-223, bFGF, and MCP-1 was 0.944, with the sensitivity of 88.88% and specificity of 94.52%.

CONCLUSIONS Postoperative colostomy infection in rectal cancer patients is primarily caused by E. coli and is associated with changes in serum miR-223, bFGF and MCP-1 levels. Abnormally high expression of miR-223 and MCP-1 and abnormally low expression of bFGF can predict postoperative colostomy infection in rectal cancer, which can provide an important basis for clinical diagnosis of postoperative infections in the rectal cancer patients.