直肠癌肠造口术后感染患者血清miR-15a、miR-29b和miR-223表达及意义  

Expression and Significance of miR-15a,miR-29b and miR-223 in Serum of Patients with Infection after Enterostomy for Rectal Cancer

作　　者：黄恒艺 黄玉斌[2] 余迅飞 黄凤 HUANG Hengyi;HUANG Yubin;YU Xunfei;HUANG Feng(The First Department of General Surgery,the Second People's Hospital of Qinzhou City,Guangxi Medical University,Qinzhou,Guangxi 535000,China;Department of General Surgery,the Second Hospital of Guangxi Medical University,Nanning 530000,China)

机构地区：[1]广西医科大学附属钦州市第二人民医院普外一科,广西壮族自治区钦州535000 [2]广西医科大学附属第二医院普外科,南宁530000

出　　处：《临床误诊误治》2023年第4期47-51,56,共6页Clinical Misdiagnosis & Mistherapy

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S201666)。

摘　　要：目的探讨直肠癌肠造口术后感染患者血清miR-15a、miR-29b和miR-223表达及意义。方法选取2020年6月—2022年6月收治的直肠癌肠造口术100例,根据肠造口术后7 d内是否发生切口感染将其分为感染组(32例)和未感染组(68例)2组。比较2组血清炎性因子和miRNA,探讨肠造口术后感染患者血清炎性因子与miRNA相关性及血清炎性因子、miRNA对肠造口术后感染预测价值,比较血清炎性因子联合与miRNA联合对肠造口术后感染预测价值、不同疗效肠造口术后感染患者治疗前和治疗10 d后血清miRNA,探讨肠造口术后感染患者血清miRNA与抗感染疗效相关性。结果术后当天,感染组血清C反应蛋白(CRP)、降钙素原(PCT)及miR-29b、miR-223高于未感染组,血清miR-15a低于未感染组;肠造口术后感染患者术后当天血清CRP、PCT与miR-15a呈负相关,与miR-29b和miR-223呈正相关(P<0.01)。血清miRNA联合预测肠造口术后感染的曲线下面积大于血清炎性因子联合预测(P<0.05)。治疗10 d后,肠造口术后感染愈合患者血清miR-15a较治疗前升高,血清miR-29b和miR-223较治疗前降低;且血清miR-15a高于未愈合患者,血清miR-29b和miR-223低于未愈合患者(P<0.01)。肠造口术后感染患者血清miR-15a与抗感染疗效呈正相关,血清miR-29b和miR-223与抗感染疗效呈负相关(P<0.01)。结论直肠癌肠造口术后患者早期血清miR-15a、miR-29b和miR-223对感染有一定预测价值,且感染患者抗感染治疗后上述指标可反映疗效。Objective To investigate the expression and significance of miR-15a,miR-29b and miR-223 in serum of patients with infection after enterostomy operation for rectal cancer.Methods A total of 100 patients receiving enterostomy after radical resection of rectal cancer treated from June 2020 to June 2022 were selected and divided into infection group(n=32)and uninfection group(n=68)according to presence or absence of incision infection within 7 d after colostomy.The serum inflammatory factors and miRNA of the two groups were compared to explore the correlation between serum inflammatory factors and miRNA in patients with infection after enterostomy,and the predictive value of serum inflammatory factors and miRNA in infection after enterostomy.The predictive value of serum inflammatory factor combination and miRNA combination for infection after enterostomy,and the serum miRNA levels of patients with infection after enterostomy before and at 10 d after treatment with different therapeutic effects were compared,and the correlation between serum miRNA and anti-infective efficacy in patients with infection after enterostomy was analyzed.Results On the day after operation,serum C-reactive protein(CRP),procalcitonin(PCT),miR-29b and miR-223 in the infection group were higher than those in the uninfection group,while serum miR-15a was lower than that in the uninfection group.Serum CRP and PCT in patients with infection were negatively correlated with miR-15a and positively correlated with miR-29b and miR-223 on the day after enterostomy(P<0.01).The area under the receiver operating characteristic(ROC)curve of serum miRNA in combination in predicting infection after enterostomy was greater than that predicted by serum inflammatory factors in combination(P<0.05).At 10 d after treatment,the serum miR-15a of the patients with infection healing after enterostomy increased,while serum miR-29b and miR-223 decreased compared with those before treatment.Serum miR-15a was higher than that of unhealed patients,while serum miR-29b and m

关 键 词：直肠肿瘤 肠造口术 感染 C反应蛋白 降钙素原 miR-15a miR-29b miR-223 

分 类 号：R735.37[医药卫生—肿瘤]