摘要
目的分析外周血辅助性T细胞17(Th17)/调节性T细胞(Treg)、程序性死亡受体-1(PD-1)+CD3^(+)、miR-146a、miR-122及血清C反应蛋白(CRP)诊断子宫内膜癌术后感染的价值,并探索子宫内膜癌术后感染的影响因素。方法选取2021年1月至2024年8月收治的子宫内膜癌手术患者289例,根据患者术后感染情况分为感染组53例、未感染组236例。收集两组临床资料并比较,采用流式细胞仪检测两组外周血Th17、Treg、PD-1+CD3^(+)水平,并计算Th17/Treg比值,采用实时荧光定量聚合酶链式反应检测两组外周血miR-146a、miR-122水平,采用酶联免疫吸附试验检测两组血清CRP水平,采用多因素logistic回归分析子宫内膜癌术后感染的影响因素,绘制受试者工作特征(ROC)曲线分析外周血Th17/Treg、PD-1+CD3^(+)、miR-146a、miR-122及血清CRP对子宫内膜癌术后感染的诊断价值。结果较未感染组,感染组合并糖尿病、贫血、辅助放化疗、开腹手术、引流置管时间≥7 d比例及外周血Th17、Th17/Treg、PD-1+CD3^(+)、miR-122和血清CRP水平升高(P<0.01),外周血Treg、miR-146a水平降低(P<0.01)。多因素logistic回归分析显示合并糖尿病、贫血、辅助放化疗、开腹手术、引流置管时间≥7 d及外周血Th17/Treg、PD-1+CD3^(+)、miR-122和血清CRP水平均是子宫内膜癌术后感染的危险因素(P<0.05,P<0.01),而外周血miR-146a是其保护因素(P<0.05)。ROC曲线分析显示,外周血Th17/Treg、PD-1+CD3^(+)、miR-146a、miR-122及血清CRP联合检测预测子宫内膜癌术后感染的曲线下面积高于外周血Th17/Treg、PD-1+CD3^(+)、miR-146a、miR-122及血清CRP单独检测(P<0.01)。结论子宫内膜癌术后感染与患者合并糖尿病、贫血、辅助放化疗、开腹手术、引流置管时间≥7 d密切相关,且外周血Th17/Treg、PD-1+CD3^(+)、miR-122及血清CRP在子宫内膜癌术后感染患者中呈高表达,而外周血miR-146a在子宫内膜癌术后感染患者中呈低表达,五者联合检测预测子宫内膜癌术后感染更具优势。
Objective To analyze the value of peripheral blood helper T cell 17(Th17)/regulatory T cell(Treg),programmed death receptor-1(PD-1)+CD3^(+),miR-146a,miR-122 and serum C-reactive protein(CRP)in the diagnosis of postoperative infection of endometrial cancer,and to explore the influencing factors of postoperative infection for endometrial cancer.Methods A total of 289 patients with endometrial cancer who underwent surgery from January 2021 to August 2024 were selected and divided into the infection group(n=53)and the non-infection group(n=236)according to the postoperative infection of the patients.Clinical data of two groups were collected and compared.The levels of Th17,Treg and PD-1+CD3^(+)in peripheral blood of the two groups were detected by flow cytometry,and the ratio of Th17/Treg was calculated.The levels of miR-146a and miR-122 in peripheral blood of the two groups were detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR).The serum CRP levels of the two groups were detected by enzymelinked immunosorbent assay(ELISA),and the influencing factors of postoperative infection in endometrial cancer were analyzed by multivariate Logistic regression.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of peripheral blood Th17/Treg,PD-1+CD3^(+),miR-146a,miR-122 and serum CRP for postoperative infection of endometrial cancer.Results Compared with the non-infection group,the infection group had higher proportions of diabetes,anemia,adjuvant chemoradiotherapy,open abdominal surgery,drainage and catheterization time≥7 d,as well as higher levels of Th17,Th17/Treg,PD-1+CD3^(+),miR-122,and serum CRP(P<0.01),while the levels of Treg and miR-146a in peripheral blood were lower(P<0.01).Multivariate Logistic regression analysis showed that combined diabetes,anemia,adjuvant chemoradiotherapy,open abdominal surgery,drainage and catheterization time≥7 d,peripheral blood Th17/Treg,PD-1+CD3^(+),miR-122 and serum CRP levels were all risk factors for postoperative infection of endometrial cancer(P<0.05,P<0.01),while miR-146a in peripheral blood was its protective factor(P<0.05).ROC curve analysis showed that the area under the curve of the combined detection of Th17/Treg,PD-1+CD3^(+),miR-146a,miR-122 in peripheral blood and serum CRP was higher than that of the individual detection of Th17/Treg,PD-1+CD3^(+),miR-146a,miR-122 and serum CRP in peripheral blood(P<0.01).Conclusion Postoperative infection of endometrial cancer is closely related to the patients'combined diabetes,anemia,adjuvant chemoradiotherapy,open surgery,and drainage and catheterization time≥7 d.Moreover,Th17/Treg,PD-1+CD3^(+),miR-122 in peripheral blood and serum CRP are highly expressed in patients with postoperative infection of endometrial cancer,while miR-146a in peripheral blood is expressed at a low level.The combined detection of the five has more advantages in evaluating postoperative infection of endometrial cancer.
作者
庄勰燕
李研
金琳茜
郑红枫
刘莹
ZHUANG Xieyan;LI Yan;JIN Linxi;ZHENG Hongfeng;LIU Ying(Department of Obstetrics and Gynecology,the Third Affiliated Hospital of Jinzhou Medical University,Jinzhou,Liaoning 121000,China;Liaoning Provincial Key Laboratory of Follicular Development and Reproductive Health,Jinzhou Medical University,Jinzhou,Liaoning 121000,China;Department of Gynecology,Ningbo Mingzhou Hospital,Ningbo,Zhejiang 315100,China)
出处
《免疫学杂志》
2025年第6期424-432,共9页
Immunological Journal
基金
国2023年辽宁省科技计划联合计划(基金)项目(辽科发规【2023】67号)。
