宫颈癌术后阴道残端感染对机体TLRs信号通路及免疫功能的影响  

Effect of vaginal stump infection on TLRs signaling pathway and immune function after cervical cancer operation

作　　者：安强[1] 杨炳[1] 刘维[1] 刘婷[1] 杨誉佳[1] 向加林[1] 刘佳云[1] AN Qiang;YANG Bing;LIU Wei;LIU Ting;YANG Yu-jia;XIANG Jia-lin;LIU Jia-yun(Affiliated Hospital of Zunyi Medical College,Zunyi,Guizhou 563003,China)

机构地区：[1]遵义医学院附属医院妇科

出　　处：《中华医院感染学杂志》2019年第15期2366-2369,2374,共5页Chinese Journal of Nosocomiology

基　　金：贵州省科技计划基金资助项目(黔科合LH字[2016]7470号)

摘　　要：目的探讨宫颈癌术后阴道残端感染对机体Toll样受体(toll-like receptors,TLRs)信号通路及免疫功能的影响。方法选取2014年2月-2018年4月于遵义医学院附属医院行手术治疗的144例宫颈癌患者为考察对象,并依据患者术后阴道残端感染与否分为感染组(n=51)和非感染组(n=93)。测定并比较两组患者手术前后TLRs信号通路相关指标、免疫功能及其他血生化指标水平变化。结果非感染组患者TLR4(0.13±0.01)×10^-2和TLR9(0.09±0.05)×10^-2水平低于感染组(0.98±0.02)×10^-2、(0.25±0.14)×10^-2(P<0.05);与手术前相比,手术后感染组患者CD3^+T淋巴细胞比例、CD4^+/CD8^+、NK细胞比例均降低(P<0.05),且低于非感染组(P<0.05);与手术前相比,手术后感染组患者IgM、IgG、IgA水平均降低(P<0.05),且低于非感染组(P<0.05);与手术前相比,手术后感染组患者CRP、IL-6、PCT水平均升高(P<0.05),且高于非感染组(P<0.05);非感染组患者CRP、IL-6、PCT水平手术前后比较差异无统计学意义。结论宫颈癌术后阴道残端感染可对患者TLRs信号通路和免疫系统产生更深远的影响,而明确术后感染原因和发病机制对提高患者预后效果具有重要意义。OBJECTIVE To investigate the effects of vaginal stump infection on toll-like receptors(TLRs)signaling pathway and immune function after cervical cancer operation.METHODS Totally 144 cases of cervical cancer patients undergoing surgery in our hospital from Feb.2014 to Apr.2018 were selected and the patients were divided into infection group(n=51)and non-infection group(n=93)according to the occurrence of postoperative vaginal stump infection.The changes of TLRs signaling pathway-related indicators,immune function and other blood biochemical indexes in the two groups before and after operation were measured and compared.RESULTS The levels of TLR4 and TLR9 in the non-infection group were(0.13±0.01)×10^-2 and(0.09±0.05)×10^-2,significantly lower than those of the infection group which were(0.98±0.02)×10^-2 and(0.25±0.14)×10^-2 respectively(P<0.05).Compared with the values before operation,the proportion of CD3^+T lymphocyte,CD4^+/CD8^+ratio and proportion of NK cells in the patients with infection decreased significantly after operation(P<0.05),and were significantly lower than those of the non-infection group(P<0.05).Compared with the levels before operation,the levels of IgM,IgG and IgA in the infection group were significantly lower after operation(P<0.05),and were significantly lower than those in the non-infection group(P<0.05).Compared with the levels before operation,the levels of CRP,IL-6 and PCT in the infection group increased significantly(P<0.05),and were significantly higher than those in the non-infection group(P<0.05).There was no significant difference in the CRP,IL-6 and PCT levels of the non-infected group before and after operation.CONCLUSION Vaginal stump infection after cervical cancer can have a more far-reaching impact on the TLRs signaling pathway and immune system,and exploration on the cause and mechanism of postoperative infection is of great significance to improve the prognosis of the patients.

关 键 词：宫颈癌 阴道残端感染 TOLL样受体 免疫功能 炎症 影响 

分 类 号：R619[医药卫生—外科学]