摘要
目的探讨微小RNA-451(miR-451)、Toll样受体4(TLR4)在肺癌合并肺部感染(PI)患者外周血中的表达及其临床意义。方法回顾性选取60例肺癌合并PI患者设为合并PI组,依据肺炎严重程度指数(PSI)评分进一步分为轻度组14例、中度组28例和重度组18例;另选取同期60例未合并PI的肺癌患者设为未合并PI组。比较合并PI组与未合并PI组患者外周血miR-451、TLR4 mRNA表达水平,采用多因素Logistic回归分析筛选影响因素;绘制受试者工作特征(ROC)曲线,以曲线下面积(AUC)评估诊断效能。比较不同严重程度肺癌合并PI患者外周血miR-451、TLR4mRNA表达水平,采用Pearson相关性分析探讨其与肺癌合并PI严重程度的相关性。结果与未合并PI组相比,合并PI组患者外周血miR-451表达水平降低,TLR4mRNA表达水平升高,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,外周血miR-451、TLR4表达水平均为肺癌患者合并PI的影响因素(P<0.05)。ROC曲线分析显示,miR-451、TLR4单独及联合诊断肺癌合并PI的AUC分别为0.805、0.779及0.888。轻度组、中度组、重度组患者外周血miR-451表达水平依次降低,TLR4 mRNA表达水平依次升高,差异有统计学意义(P<0.05)。Pearson相关性分析显示,外周血miR-451表达水平与PSI评分、TLR4表达水平呈负相关(r=-0.697、-0.579,P<0.001),外周血TLR4表达水平与PSI评分呈正相关(r=0.751,P<0.001)。结论肺癌合并PI患者外周血中miR-451、TLR4均异常表达,且其表达水平与PI严重程度密切相关,两者联合检测对肺癌合并PI具有较高的诊断价值。
Objective To investigate the expression of microRNA-451(miR-451)and toll-like receptor 4(TLR4)in peripheral blood of lung cancer patients complicated with pulmonary infection(PI)and their clinical significance.Methods A total of 60 lung cancer patients complicated with PI were retrospectively selected and were included in PI group.Based on the pneumonia severity index(PSI)score,they were further divided into mild group(14 cases),moderate group(28 cases)and severe group(18 cases).Additionally,60 patients with lung cancer without PI during the same period were selected as non-PI group.The expression levels of miR-451 and TLR4 mRNA in peripheral blood were compared between the PI and non-PI groups.Multivariate Logistic regression analysis was used to screen for influencing factors.A receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)was used to evaluate the diagnostic efficacy.The expression levels of miR-451 and TLR4 mRNA in peripheral blood of lung cancer patients complicated with PI of different severities were compared.Pearson correlation analysis was employed to explore the correlation between their expression levels and the severity of lung cancer complicated with PI.Results Compared with the non-PI group,the expression level of miR-451 in peripheral blood of patients in the PI group was decreased,while the expression level of TLR4 mRNA was increased(P<0.05).Multivariate Logistic regression analysis revealed that the expression levels of miR-451 and TLR4 in peripheral blood were both influencing factors for lung cancer patients complicated with PI(P<0.05).ROC curve analysis showed that the AUC values for the diagnosis of lung cancer complicated with PI using miR-451,TLR4 alone,and their combination were 0.805,0.779 and 0.888,respectively.In the mild,moderate,and severe groups,the expression level of miR-451 in peripheral blood decreased in sequence,while the expression level of TLR4 mRNA increased in sequence(P<0.05).Pearson correlation analysis indicated that the expression level of miR-451 in peripheral blood was negatively correlated with the PSI score and the expression level of TLR4(r=-0.697,-0.579,P<0.001),while the expression level of TLR4 in peripheral blood was positively correlated with the PSI score(r=0.751,P<0.001).Conclusion Both miR-451 and TLR4 are abnormally expressed in the peripheral blood of lung cancer patients complicated with PI,and their expression levels are closely related to the severity of PI.The combined detection of the two has a high diagnostic value for lung cancer complicated with PI.
作者
马强
谌登珍
MA Qiang;CHEN Dengzhen(Department of Respiratory and Critical Care Medicine,Shangluo Central Hospital of Shaanxi Province,Shangluo,shaanxi,726000;Department of Respiratory Medicine,Shangluo Central Hospital of Shaanxi Province,Shangluo,shaanxi,726000)
出处
《实用临床医药杂志》
2025年第14期13-17,共5页
Journal of Clinical Medicine in Practice
基金
陕西省重点研发计划项目(2020SF-116)。
