食管癌术后肺部感染血浆TNF基因微卫星多态性及与预后的关系

Relationship between microsatellite polymorphisms of plasma tumor necrosis factor gene and prognosis of esophageal carcinoma patients with postoperative pulmonary infection

目的探讨食管癌术后肺部感染患者血浆肿瘤坏死因子(TNF)基因微卫星多态性及其与预后的关系。方法选取2018年1月-2020年9月邢台市人民医院食管癌术后继发肺部感染患者115例为感染组,系统抽样选取同期食管癌根治术未发生感染患者148例为对照组。根据肺部感染患者预后情况分为生存组88例和病死组27例。采用聚合酶链式反应进行DNA扩增,聚丙烯酰胺凝胶电泳-银染技术进行微卫星分型。结果感染组携带TNF c 1/1基因型的频率为39.13%高于对照组(P<0.05),携带TNF c 1等位基因的频率为63.04%高于对照组(P<0.05);肺部感染患者中病死组携带TNF c 1/1基因型的频率为59.26%高于生存组(P<0.05),携带TNF c 1等位基因的频率为75.93%高于生存组(P<0.05);低蛋白血症、血液高凝状态、携带TNF c 1/1基因型是导致患者预后不良的危险因素(P<0.05)。TNF c 1/1基因型患者住院时间长于TNF c 1/2基因型、TNF c 2/2基因型(P<0.05)。结论TNF基因微卫星多态性与食管癌术后肺部感染及其预后有关,TNF c 1/1基因型可能增加肺部感染易感性,并且导致不良预后。

OBJECTIVE To explore the relationship between microsatellite polymorphisms of plasma tumor necrosis factor(TNF)gene and prognosis of esophageal carcinoma patients with postoperative pulmonary infection.METHODS Totally 115 esophageal carcinoma patients with postoperative secondary pulmonary infection who were treated in Xingtai People’s Hospital from Jan 2018 to Sep 2020 were assigned as the control group,meanwhile,148 esophageal carcinoma patients who underwent radical surgery but did not have infection were systematically sampled and selected as the control group.The patients with pulmonary infection were divided into the survival group with 88 cases and the death group with 27 cases according to the prognosis.DNA was amplified by polymerase chain reaction,and microsatellite typing was carried out by using polyacrylamide gel electrophoresis-silver staining technique.RESULTS The frequency of TNF c 1/1 genotype of the infection group was 39.13%,significantly higher than that of the control group(P<0.05);the frequency of TNF c 1 allele of the infection group was 63.04%,significantly higher than that of the control group(P<0.05).Among the patients with pulmonary infection,the frequency of TNF c 1/1 genotype of the death group was 59.26%,significantly higher than that of the survival group(P<0.05);the frequency of TNF c 1 allele of the death group was 75.93%,significantly higher than that of the survival group(P<0.05).The hypoproteinemia,hypercoagulable state and TNF c 1/1 genotype were the risk factors for unfavorable prognosis of the patients(P<0.05).The length of hospital stay of the patients with TNF c 1/1 genotype was significantly longer than that of the patients with TNF c 1/2 genotype and TNF c 2/2 genotype(P<0.05).CONCLUSION The microsatellite polymorphisms of TNF gene are associated with the postoperative pulmonary infection and prognosis of the patients with esophageal carcinoma,and the TNF c 1/1 genotype may increase the susceptibility to the pulmonary infection and result in the poor prognosis.