TNFα-308和TOLL样受体4基因多态性与老年胃癌根治术后腹腔感染和临床转归的关联

Correlation of polymorphisms of TNFα-308 and Toll-like receptor 4 genes with abdominal infection and clinical outcomes in elderly patients after radical resection of gastric cancer

目的分析肿瘤坏死因子α-308(TNFα-308)和TOLL样受体4(TLR4)基因多态性与老年胃癌根治术后腹腔感染和临床转归的关联性。方法回顾性分析2016年1月-2018年1月东营区人民医院普外科收治的行根治术治疗的78例老年胃癌患者的临床资料,根据术后有无腹腔感染分为感染组(n=10)和未感染组(n=68);随访3年,根据生存情况分为存活组(n=57)和死亡组(n=21),采用限制性片段长度多态性聚合酶链反应(PCR-RFLP)分析TNFα-308、TLR4基因多态性,并分析TNFα-308、TLR4基因多态性与腹腔感染和临床转归的关联性。结果感染组TNFα-308 GG基因频率及G等位基因频率高于未感染组,A等位基因频率低于未感染组(P<0.05)。多因素Logistic回归分析显示,TNFα-308位点GG基因型(OR=1.401,95%CI:1.043~1.897)发生胃癌根治术后腹腔感染的风险升高(P<0.05)。死亡组TNFα-308 GG基因频率及G等位基因频率高于生存组,AA基因频率及A等位基因频率低于生存组(P<0.05)。Cox回归分析显示,TNFα-308位点GG基因型(OR=1.163,95%CI:1.025~1.109)发生死亡的风险升高,AA基因型(OR=1.057,95%CI:1.067~1.178)发生死亡的风险降低(P<0.05)。结论TNFα-308 GG基因型及G等位基因频率能增加老年胃癌根治术后腹腔感染和病死率,TLR4基因多态性与老年胃癌根治术后腹腔感染和临床转归无相关性。

OBJECTIVE To analyze the association of tumor necrosis factorα-308(TNFα-308)and Toll-like receptor 4(TLR4)gene polymorphisms with abdominal infection and clinical outcomes in elderly patients after radical resection of gastric cancer.METHODS The clinical data of 78 elderly patients who underwent radical resection of gastric cancer in the General Surgery Department of Dongying District People’s Hospital between Jan.2016 and Jan.2018 was retrospectively analyzed.According to the presence or absence of postoperative abdominal infection,the patients were divided into the infection group(n=10)and non-infection group(n=68).The patients were followed up for 3 years,and divided into the survival group(n=57)and death group(n=21).TNFα-308 and TLR4 gene polymorphisms were analyzed by restriction fragment length polymorphism polymerase chain reaction(PCR-RFLP).The association of TNFα-308 and TLR4 gene polymorphisms with abdominal infection and clinical outcomes was analyzed.RESULTS The frequency of GG genotype and G allele at TNFα-308 gene in the infection group were significantly higher than those in the non-infection group,while A allele frequency was lower than that in the non-infection group(P<0.05).Multivariate logistic regression analysis showed that GG genotype of TNFα-308 gene(OR=1.401,95%CI:1.043-1.897)was a risk factor for abdominal infection after radical resection of gastric cancer(P<0.05).GG gene frequency and G allele frequency at TNFα-308 gene in the death group were significantly higher than those in the survival group.AA gene frequency and A allele frequency were significantly lower than those in the survival group(P<0.05).Cox regression analysis showed that the GG genotype of TNFα-308 gene(OR=1.163,95%CI:1.025-1.109)was a risk factor of death,while AA genotype(OR=1.057,95%CI:1.067-1.178)was a protective factor(P<0.05).CONCLUSION GG gene frequency and G allele frequency at TNFα-308 gene can increase the incidence of abdominal infection and death in elderly patients after radical resection of gastric cancer.There was no correlation between TLR4 gene polymorphisms and abdominal infection and clinical outcomes in elderly patients after radical resection of gastric cancer.