直肠癌术后结肠造口感染与外周血CD36/mTORC1信号通路及MCP-1、sTREM-1表达的关系  

Association between the postoperative colonic fistula infection and expressions of CD36/mTORC1 signaling pathways,MCP-1 and sTREM-1 in peripheral blood of rectal cancer patients undergoing colostomy

作　　者：王晓莉[1] 李丽[1] 周新宇 徐慧 WANG Xiao-li;LI Li;ZHOU Xin-yu;XU Hui(Qingdao Hiser Hospital Affiliated of Qingdao University(Qingdao Traditional Chinese Medicine Hospital),Qingdao,Shandong 266033,China)

机构地区：[1]青岛大学附属青岛市海慈医院(青岛市中医医院)肛肠科,山东青岛266033 [2]青岛大学附属青岛市海慈医院(青岛市中医医院)外科,山东青岛266033

出　　处：《中华医院感染学杂志》2024年第21期3296-3300,共5页Chinese Journal of Nosocomiology

基　　金：山东省中医药科技基金资助项目(M-2023029)。

摘　　要：目的探究直肠癌术后结肠造口感染与外周血分化抗原36(CD36)/雷帕霉素靶蛋白复合物1(mTORC1)信号通路及单核细胞趋化蛋白(MCP)-1、可溶性髓样细胞触发受体-1(sTREM-1)表达的关系。方法选取2020年9月-2023年9月青岛大学附属青岛市海慈医院(青岛市中医医院)收治的直肠癌术后患者151例为研究对象,其中发生结肠造口感染患者25例纳入感染组,术后未发生结肠造口感染患者126例纳入非感染组。统计感染组病原菌分布;统计两组大肠埃希菌、肠球菌、乳酸杆菌、双歧杆菌水平变化;比较两组外周血CD36、mTORC1、MCP-1、sTREM-1水平,四指标对直肠癌术后患者结肠造口感染的诊断价值利用受试者工作特征(ROC)曲线进行分析。结果25例感染组患者检出29株病原菌,其中革兰阴性菌占比最高,并以大肠埃希菌居多;与非感染组相比,感染组乳酸杆菌、双歧杆菌水平降低,大肠埃希菌、肠球菌、CD36、mTORC1、MCP-1、sTREM-1水平升高(P<0.05)。CD36、mTORC1、MCP-1、sTREM-1联合检测诊断直肠癌术后患者结肠造口感染的曲线下面积(AUC)值高于各项单一检测(P<0.05)。结论直肠癌术后结肠造口感染患者病原菌主要为革兰阴性菌,且肠道菌群失调;直肠癌术后患者结肠造口感染中CD36/mTORC1通路被激活,MCP-1、sTREM-1呈高表达,且其联合检测诊断价值高。OBJECTIVE To explore the relationship between the postoperative colonic fistula infection and the expressions of cluster of differentiation 36(CD36)/mammalian target of rapamycin complex l(mTORCl)signaling pathways,monocyte chemoattractant protein(MCP)-1 and soluble triggering receptor expressed on myeloid cells(sTREM-1)in peripheral blood of the rectal cancer patients undergoing colostomy.METHODS Totally 151 rectal cancer patients who underwent the surgery in Qingdao Hiser Hospital Affiliated of Qingdao University(Qingdao Traditional Chinese Medicine Hospital)from Sep.2020 to Sep.2023 were recruited as the research subjects,25 of whom had colonic fistula infection and were assigned as the infection group,and 126 did not have postoperative colonic fistula infection and were assigned as the non-infection group.The distribution of pathogens isolated from the infection group was statistically analyzed.The changes of colony counts of Escherichia coli,Enterococci,Lactobacillus and Bifidobacterium were observed and compared between the two groups.The levels of peripheral blood CD36,mTORC1,MCP-1 and sTREM-1 were compared between the two groups.The values of the four indexes in diagnosis of the postoperative colonic fistula infection in the rectal cancer patients were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Totally 29 strains of pathogens were isolated from the 25 patients of the infection group,among which gram-negative bacteria were dominant,and Escherichia coli was the predominant species.The levels of Lactobacillus and Bifidobacterium of the infection group were lower than those of the non-infection group,while the levels of E.coli,Enterococci,CD36,mTORC1,MCP-1 and sTREM-1 of the infection group were higher than those of the non-infection group(P<0.05).The area under the curve(AUC)of the joint detection of CD36,mTORC1,MCP-1 and sTREM-1 was higher than that of the single detection in diagnosis of the postoperative colonic fistula infection in the rectal cancer patients(P<0.05).CONCLUS

关 键 词：直肠癌 结肠造口感染 病原菌 肠道菌群 分化抗原36 雷帕霉素靶蛋白复合物1 单核细胞趋化蛋白-1 可溶性髓样细胞触发受体-1 受试者工作特征曲线 

分 类 号：R735.3[医药卫生—肿瘤]