乳腺癌术后切口感染病原学及mTORC1/HIF1α通路相关基因表达  

Etiological characteristics of postoperative incision infection and expressions of mTORC1/HIF1αpathwayys-related genes in breast cancer patients

作　　者：潘常辉[1] 黎柯渝 王佳[1] 古芳尤 肖红英[1] PAN Chang-hui;LI Ke-yu;WANG Jia;GU Fang-you;XIAO Hong-ying(Sichuan Provincial Cancer Hospital,Chengdu,Sichuan 61004l,China)

机构地区：[1]四川省肿瘤医院急诊科,四川成都610041

出　　处：《中华医院感染学杂志》2023年第17期2678-2682,共5页Chinese Journal of Nosocomiology

基　　金：四川省卫生和计划生育委员会科研项目(17PJ300)。

摘　　要：目的探究乳腺癌术后切口感染病原学特点及哺乳动物雷帕霉素靶蛋白(mTORC1)和缺氧诱导因子1α(HIF1α)通路相关因子的诊断价值.方法收集2018年1月-2020年12月四川省肿瘤医院收治的乳腺癌合并术后切口感染患者80例为感染组、未并发感染患者45例为非感染组,80名体检健康女性为对照组.分析感染组切口感染病原学特点,采用PCR法检测外周血mTORC1/HIF1α通路相对表达量,受试者工作特征(ROC)曲线评估mTORC1/HIF1α相关因子对切口感染的诊断价值.结果80例乳腺癌术后切口感染患者共分离出127株病原菌,其中革兰阴性菌78株占61.42%,革兰阳性菌46株占36.22%,真菌3株占2.36%;与对照组比较,感染组和非感染组患者mTORC1、HIF1α、葡萄糖转运蛋白1(Glut1)、M2-型丙酮酸激酶(PKM2)、糖基磷脂酰肌醇(GPI)和肌钙蛋白(TPI)相对表达量上调,且感染组患者上述各指标表达高于非感染组(P<0.05);ROC曲线结果显示,mTORC1、HIF1α、Glut1、PKM2、GPI和TPI诊断术后切口感染的曲线下面积(AUC)均>0.7,具有较好的预测价值.结论乳腺癌术后切口感染患者mTORC1/HIF1α通路的表达水平显著升高,且各指标对术后感染具有诊断价值.OBJECTIVE To explore the etiological characteristics of postoperative incision infection in the breast cancer patients and analyze the diagnostic values of mammalian target of rapamycin complex 1(mTORC1)/hypoxia inducible factor 1α(HIF1α)pathways-related genes.METHODS Totally 80 breast cancer patients who were complicated with postoperative incision infection and treated in Sichuan Provincial Cancer Hospital from Jan 2o18 to Dec 2020 were assigned as the infection group,45 patients who were not complicated with infection were assigned as the non-infection,and 8o healthy women who received physical examination were chosen as the control group.The etiological characteristics of the incision infection of the infection group were analyzed,the relative expression levels of mTORC1/HIF1α pathways in peripheral blood were detected by PCR,and the values of mTORC1/HIF1α-related factors in diagnosis of the incision infection were evaluated by means of receiver operating characteristic(ROC)curve.RESULTS Totally 127 strains of pathogens were isolated from the 80 breast cancer patients complicated with postoperative incision infection,78(61.42%)of which were gram-negative bacteria46(36.22%)were gram-positive bacteria,and 3(2.36%)were fungi.The relative expression levels of mTORCl,HIF1α,glucose transporter 1(Glut1),M2 pyruvate kinase(PKM2),glycosylphosphatidylinositol(GPI)and troponin(TPI)were higher in the infection group and the non-infection group than in the control group,and the relative expression levels of the above indexes of the infection group were higher than those of the non-infection group(P<0.05).ROC curve analysis showed that the areas under curves(AUCs)of mTORC1,HIF1α,Glut1,PKM2,GPI and TPI were all greater than O.7 in diagnosis of the postoperative incision infection,the indexes had high predictive values.CONCLUSION The breast cancer patients complicated with postoperative incision infection show remarkable rise of expression levels of mTORC1/HIF1αpathways,which have values in diagnosis of postoperative

关 键 词：乳腺癌 术后切口感染 病原菌 外周血单个核细胞 哺乳动物雷帕霉素靶蛋白/缺氧诱导因子1α通路 

分 类 号：R737.9[医药卫生—肿瘤]