Pathogens and expressions of MEG3/miR-223/NLRP3 axis in peripheral blood for thoracoscopic lobectomy patients with postoperative pulmonary infections

OBJECTIVE To explore the distribution of pathogens isolated from the thoracoscopic lobectomy patients with postoperative pulmonary infections and observe the expressions of maternal expression gene 3 (MEG3)/microribonucleic acid-223 (miR-223)/ nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) axis in peripheral blood.

METHODS Totally 48 lung cancer patients who underwent thoracoscopic lobectomy and had postoperative pulmonary infections in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from Jun. 2021 to Jun.2024 were assigned as the infection group, meanwhile, 31 lung cancer patients who underwent thoracoscopic lobectomy but did not have postoperative infections were chosen as the no infection group. The sputum specimens were collected from the infection group, the distribution of isolated pathogens was analyzed. The clinical data and the expression MEG3, miR-223 and NLRP3 were observed and compared between the two groups. The values of MEG3, miR-223 and NLRP3 in prediction of the postoperative infections were analyzed by receiver operating characteristic (ROC) curves.

RESULTS Totally 63 strains of pathogens were isolated from the 48 thoracoscopic lobectomy patients with postoperative pulmonary infections, 33 (52.38%) of which were gram-negative bacteria, 25 (39.68%) were gram-positive bacteria, and 5 (7.94%) were fungi. There were significant differences in age, diabetes mellitus, chronic obstructive pulmonary disease (COPD), operation duration, and expression levels of MEG3, miR-223 and NLRP3 between the infection group and the no infection group (P < 0.05). ROC curve analysis showed that the areas under the curves of MEG3, miR-223 and NLRP3 and the joint detection of the three indexes were 0.861, 0.760, 0.912 and 0.968, respectively, in prediction of the postoperative pulmonary infections, and the predictive efficiency of the joint detection was highest (P < 0.05).

CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the thoracoscopic lobectomy patients with postoperative pulmonary infections, the occurrence and progression of the infections may be closely associated with the activation of MEG3/miR-223/NLRP3 axis. The joint detection of the three indexes can effectively predict the postoperative pulmonary infections in the thoracoscopic lobectomy patients.