TNFc微卫星多态性与肝癌TACE介入术后感染易感性的关联

Correlation between microsatellite polymorphisms of TNFc and susceptibility to postoperative infection in liver cancer patients undergoing TACE

目的 分析肿瘤坏死因子β基因内含子的微卫星多态性(TNFc)与肝癌经导管动脉化疗栓塞术(TACE)介入术后感染易感性的关联。方法 选取2021年1月-2021年9月南通市第一人民医院TACE术后感染的肝癌患者61例为研究组,同期TACE术后未发生感染患者79例为对照组。分析术后感染部位及病原学特点,采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)检测TNFc微卫星基因多态性及其与术后感染易感性的关联。结果 TACE术后感染部位以胆道感染(42.62%)为主,革兰阴性菌(76.39%)为主要病原菌;研究组患者TNFc基因C1C1基因型频率和C1等位基因频率高于对照组(P<0.05);C1C1型感染患者血清C-反应蛋白(CRP)和降钙素原(PCT)水平高于C1C2/C2C2型患者(P<0.05);TACE术后感染患者不同TNFc微卫星基因型术后住院时间和病死率比较差异无统计学意义。结论 肝癌TACE介入术后感染以胆道感染为主,TNFc微卫星C1C1基因型和C1等位基因可能增加患者术后感染易感性。

OBJECTIVE To analyze the correlation between microsatellite polymorphisms of tumor necrosis factor beta gene intron(TNFc) and susceptibility to postoperative infection in liver cancer patients undergoing transcatheter arterial chemoembolization(TACE).METHODS From Jan 2021 to Sep 2021,totally 61 liver cancer patients who underwent TACE and had postoperative infection were assigned as the study group,meanwhile,79 patients who underwent TACE but did not have postoperative infection were chosen as the control group.The postoperative infection sites and etiological characteristics were analyzed,the microsatellite polymorphisms of TNFc were detected by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP),and the association with the susceptibility to postoperative infection was observed.RESULTS Among the TACE patients with postoperative infection,the patients with biliary tract infection accounted for 42.62%.Gram-negative bacteria were dominant among the pathogens,accounting for 76.39%.The frequencies of C1 C1 genotype and C1 allele of TNFc gene were significantly higher in the study group than in the control group(P<0.05).Among the patients with infection,the levels of serum C-reactive protein(CRP) and procalcitonin(PCT) of the patients with C1 C1 genotype were significantly higher than those of the patients with C1 C2/C2 C2 genotype(P<0.05).Among the TACE patients with postoperative infection,there were no significant differences in the postoperative length of hospital stay and mortality rate among the patients with different microsatellite genotypes of TNFc.CONCLUSION Among the liver cancer patients who undergo TACE and have postoperative infection,the patients with biliary tract infection are dominant.The microsatellite C1 C1 genotype and C1 allele of TNFc may increase the risk of susceptibility to postoperative infection.