下咽癌放疗后口腔感染影响因素及口腔黏膜STAT3、Bcl-2表达水平

Influencing factors for oral infection in hypopharyngeal carcinoma patients after radiotherapy and expressions of STAT3 and Bcl-2 in oral mucosa

目的分析下咽癌放疗后口腔感染影响因素及口腔黏膜信号传导与转录激活因子3(STAT3)、B淋巴细胞瘤-2(Bcl-2)表达水平。方法选择2018年1月-2021年10月于天津市第五中心医院进行放疗治疗的下咽癌患者221例为研究对象,根据下咽癌放疗后口腔感染发生情况将患者分为感染组84例和未感染组137例,采用Logistic回归分析影响下咽癌放疗后口腔感染的危险因素,并比较两组患者口腔黏膜STAT3、Bcl-2 mRNA表达差异。结果221例进行放疗治疗的下咽癌患者中有84例发生口腔感染,感染率为38.01%,感染主要部位为颊部和牙龈占比分别为44.05%和28.57%;共检出96株病原菌,其中革兰阴性菌占46.88%、革兰阳性菌占34.38%;多因素Logistic回归分析显示年龄、侵入性操作、接受化疗、抗菌药物使用种类、口腔自洁习惯以及口腔环境均为引起下咽癌放疗后口腔感染的影响因素(P<0.05);感染组口腔黏膜STAT3、Bcl-2 mRNA表达高于未感染组(P<0.05)。结论下咽癌患者放疗后口腔感染病原菌以革兰阴性菌为主,年龄、侵入性操作、接受化疗、抗菌药物使用种类、口腔自洁习惯以及口腔环境均可能是引起下咽癌放疗后口腔感染的影响因素,且口腔黏膜STAT3、Bcl-2表达水平明显升高。

OBJECTIVE To explore the influencing factors for oral infection in hypopharyngeal carcinoma patients after radiotherapy and analyze the expressions of signal transducer and activator of transcriptions 3(STAT3)and B-cell lymphoma-2(Bcl-2)in oral mucosa.METHODS Totally 221 patients with hypopharyngeal carcinoma who were treated with radiotherapy in Tianjin Fifth Central Hospital from Jan 2018 to Oct 2021 were recruited as the research subjects and were divided into the infection group with 84 cases and the no infection group with 137 cases according to the status of oral infection after the radiotherapy.Logistic regression analysis was performed for the risk factors for the oral infection in the hypopharyngeal carcinoma patients after the radiotherapy.The expression levels of STAT3 and Bcl-2 mRNA in oral mucosa were observed and compared between the two groups of patients.RESULTS Among the 221 hypopharyngeal carcinoma patients who were treated with radiotherapy,84 had oral infection,with the infection rate 38.01%;the patients with cheek infection accounted for 44.05%,and the patients with gum infection accounted for 28.57%.Totally 96 strains of pathogens were isolated,46.88%of which were gram-negative bacteria,and 34.38%were gram-positive bacteria.Multivariate logistic regression analysis showed that age,invasive procedures,chemotherapy,types of antibiotics,habit of oral self-cleaning and oral environment were the influencing factors for the oral infection in the hypopharyngeal carcinoma patients after radiotherapy(P<0.05).The expression levels of STAT3 and Bcl-2 mRNA in oral mucosa were higher in the infection group than in the no infection group(P<0.05).CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the hypopharyngeal carcinoma patients with oral infection after radiotherapy.The age,invasive procedures,chemotherapy,types of antibiotics,habit of oral self-cleaning and oral environment are the influencing factors for the oral infection,and the expression levels of oral mucosa STAT3 and Bcl-2 are significantly elevated.