口腔鳞癌根治术后口腔感染病原菌及影响因素  

Pathogens isolated from oral squamous cell carcinoma patients with infection after radical resection and influencing factors

作　　者：郭建康[1] 屠永奇 高振杰 李娜[1] 万卫星 GUO Jian-kang;TU Yong-qi;GAO Zhen-jie;LI Na;WAN Wei-xing(Henan Vocational College of Nursing,Anyang,Henan 455000,China;不详)

机构地区：[1]河南护理职业学院口腔系,河南安阳455000 [2]安阳市肿瘤医院放疗科,河南安阳455000 [3]郑州大学第一附属医院口腔科,河南郑州450000 [4]安阳市肿瘤医院内科,河南安阳455000

出　　处：《中华医院感染学杂志》2022年第18期2842-2846,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190189)。

摘　　要：目的 探究口腔鳞癌根治术后口腔感染患者口腔黏膜Toll样受体2(TLR2)、TLR4 mRNA表达,为临床预防术后感染提供参考。方法 选择2016年8月-2018年8月医院收治的口腔鳞癌根治术患者98例,根据术后口腔感染情况分为感染组26例,非感染组72例,分析口腔感染病原菌分布,探究术后口腔感染影响因素,聚合酶链式反应(PCR)检测口腔黏膜TLR2、TLR4 mRNA表达量,受试者工作特征(ROC)曲线分析TLR2、TLR4及其比值对预测术后口腔感染的价值。结果 26例口腔感染患者共分离病原菌26株,其中革兰阳性菌19株占73.08%,革兰阴性菌7株占26.92%;多因素分析结果显示,年龄、肿瘤面积为口腔感染影响因素(P<0.05);感染组患者TLR2、TLR4 mRNA及其比值高于非感染组(P<0.05),IL-6、IL-8及TNF-α水平高于非感染组(P<0.05);ROC曲线分析显示,TLR2、TLR4及其比值预测术后口腔感染的曲线下面积(AUC)分别为0.871、0.895、0.938。结论 TLR2、TLR4 mRNA异常表达与口腔鳞癌根治术后患者口腔感染密切相关,可作为行口腔鳞癌根治术患者术后口腔感染的预测指标。OBJECTIVE To explore the expression of Toll-like receptor 2(TLR2)/Toll-like receptor 4(TLR4) mRNA in oral mucosa of oral squamous cell carcinoma patients with infection after radical resection so as to provide guidance for clinical prevention of postoperative infection.METHODS Totally 98 oral squamous cell carcinoma patients who underwent radical resection from Aug 2016 to Aug 2018 were enrolled in the study and divided into the infection group with 26 cases and the no infection group with 72 cases according to the status of postoperative oral infection.The distribution of pathogens causing oral infection was analyzed,the influencing factors for postoperative oral infection were investigated,the expression levels of TLR2 and TLR4 mRNA in oral mucosa were detected by polymerase chain reaction(PCR),and the values of TLR2,TLR4 and their ratio in prediction of postoperative oral infection were analyzed by receiver operating characteristic(ROC) curve.RESULTS Totally 26 strains of pathogens were isolated from 26 patients with oral infection,19(73.08%) of which were gram-positive bacteria,7(26.92%) were gram-negative bacteria.Multivariate analysis showed that age and size of tumor were influencing factors for the oral infection(P<0.05).The expression levels of TLR2,TLR4 and their ratio were significantly higher in the infection group than in the no infection group(P<0.05);the levels of IL-6,IL-8 and TNF-α of the infection group were significantly higher than those of the no infection group(P<0.05).ROC curve analysis indicated that the areas under curves(AUCs) of TLR2,TLR4 and their ratio were respectively 0.871,0.895 and 0.938 in prediction of postoperative oral infection.CONCLUSION The abnormal expression of TLR2 and TLR4 mRNA is closely associated with the postoperative oral infection in the oral squamous cell carcinoma patients undergoing radical rection,and the two indexes can be used for prediction of the postoperative oral infection.

关 键 词：口腔癌根治术 口腔感染 TOLL样受体2 Toll样受体4 病原菌 影响因素 

分 类 号：R739.85[医药卫生—肿瘤]