胃癌术后肺部感染p38 MAPK信号和CA153与CTCs及其影响因素

Influencing factors of pulmonary infection after gastric cancer surgery and peripheral blood p38 MAPK signal,CA153 and CTCs

目的 探讨胃癌患者术后肺部感染外周血p38丝裂原活化蛋白激酶(p38 MAPK)信号和糖蛋白抗原153(CA153)与循环肿瘤细胞(CTCs)及其影响因素。方法 选取2016年1月-2021年1月重庆市急救医疗中心普外科行胃癌根治术的胃癌患者98例,根据术后1个月内是否发生肺部感染分为感染组21例和未感染组77例;记录两组性别、年龄等临床特征,检测两组血清CA153水平,采用Cell Search系统检测两组外周血CTCs阳性表达率,采用蛋白质免疫印迹法检测两组p38 MAPK、细胞外调节蛋白激酶1/2(ERK1/2)、c-Jun氨基末端激酶(JNK)、p-p38 MAPK、p-ERK1/2和p-JNK蛋白表达水平;采用Logistic回归分析胃癌术后肺部感染的影响因素。结果 胃癌患者术后肺部感染病原菌以革兰阴性菌为主(59.38%);感染组血清CA153水平、CTCs阳性表达率和p-p38 MAPK、p-ERK1/2、p-JNK水平均高于未感染组(P<0.05);Logistic回归分析,吸烟史、合并糖尿病及置管时间是胃癌患者术后肺部感染的影响因素(P<0.05)。结论 吸烟史和合并糖尿病及置管时间是胃癌患者术后肺部感染的影响因素,感染可引起患者CA153、CTCs和p-p38 MAPK、p-ERK1/2、p-JNK蛋白水平升高。

OBJECTIVE To investigate the factors influencing postoperative pulmonary infection and changes in peripheral blood p38 mitogen-activated protein kinase(p38 MAPK) signal,carbohydrate antigen 153(CA153),and circulating tumor cells(CTCs) in patients with gastric cancer.METHODS A total of 98 patients with gastric cancer undergoing radical resection in General Surgery Department of Chongqing Emergency Medical Center between Jan.2016 and Jan.2021 were selected,and were divided into 21 cases of the infection group and 77 cases of the non-infection group according to presence or absence of pulmonary infection within 1 month after surgery.The clinical characteristics such as gender and age in both groups were recorded.The level of serum CA153 was detected by electrochemiluminescence.The positive expression rate of peripheral blood CTCs was detected by Cell Search system.The expression levels of p38 MAPK,extracellular regulated protein kinases 1/2(ERK1/2),c-Jun N-terminal kinase(JNK),p-p38 MAPK,p-ERK1/2 and p-JNK proteins were detected by Western blot.The influencing factors of postoperative pulmonary infection in gastric cancer were analyzed by binary Logistic regression analysis.RESULTS The main pathogens of pulmonary infection after gastric cancer surgery were mainly Gram-negative bacteria(59.38%).The level of serum CA153,positive expression rate of CTCs and expression levels of p-p38 MAPK,p-ERK1/2 and p-JNK proteins in the infection group were higher than those in non-infection group(P<0.05).Logistic regression analysis showed that smoking history,diabetes mellitus and catheterization time were influencing factors of postoperative pulmonary infection in patients with gastric cancer(P<0.05).CONCLUSION Smoking history,combined diabetes mellitus and long catheterization time were influencing factors of postoperative pulmonary infection in patients with gastric cancer,and the infection caused elevated levels of CA153,CTCs,p-p38 MAPK,p-ERK1/2 and p-JNK proteins in patients.