喉癌患者术后外周血Fas/Fasl水平及其基因多态性与切口感染的关联

Relationship of peripheral blood Fas/Fasl level and gene polymorphism with incision infection in patients with laryngeal carcinoma after surgery

目的探究喉癌患者外周血Fas/Fasl水平及其基因多态性以及外周血表达与其术后发生切口感染的相关性。方法选取2018年1月-2021年10月在天津市第五中心医院接受手术治疗的喉癌患者97例,根据其术后是否发生切口感染分为感染组和未感染组,各有患者16例、81例,回顾性统计对比两组患者的一般资料、治疗情况以及外周血Fas/Fasl表达情况。结果两组患者年龄、临床分期、手术方式、应用抗菌药物、手术时间、术中出血量比较有统计学差异(P<0.05);感染组外周血T淋巴细胞表面Fas表达低于未感染组(P<0.05),两组外周血T淋巴细胞均未检测出Fasl;感染组血清sFas浓度低于未感染组(P<0.05),血清sFasl浓度高于未感染组(P<0.05);两组患者Fasl-844位点基因型以及Fas-670位点基因型差异均无统计学意义,但感染组患者Fasl-844位点C等位基因以及Fas-670位点A等位基因占比高于未感染组(P<0.05);Logistic分析显示,外周血T淋巴细胞Fas低表达是喉癌患者术后切口感染的独立危险因素(P<0.05)。结论喉癌患者术后切口感染的独立危险因素为外周血T淋巴细胞Fas低表达,实际临床治疗可根据外周血T淋巴细胞Fas表达情况对患者术后感染风险进行评估以及时采取预防措施,改善患者预后。

OBJECTIVE To investigate the correlation of peripheral blood Fas/Fasl level and gene polymorphism with incision infection in patients with laryngeal carcinoma after surgery.METHODS A total of 97 patients with laryngeal carcinoma who underwent surgery in Tianjin Fifth Central Hospital between Jan 2018 and Oct 2021 were recruited and divided into the infected group(n=16)and the uninfected group(n=81)according to whether the incision infection occurred after surgery.General data,treatments and peripheral blood Fas/Fasl expression level in the two groups were analyzed.RESULTS There were significant differences in age,clinical stage,operation method,use of antibiotics,operation time and intraoperative blood loss between the two groups(P<0.05).Fas expression on the surface of peripheral blood T lymphocytes in the infected group was lower than that in the uninfected group(P<0.05),and Fasl was not detected in peripheral blood T lymphocytes in either group.Serum sFas level in the infected group was lower than that in the uninfected group(P<0.05),and serum sFasl level was higher than that in the uninfected group(P<0.05).There was no significant difference in Fasl-844 genotype and Fas-670 genotype between the two groups,but the proportions of Fasl-844 C allele and Fas-670 A allele in the infected group were higher than those in the uninfected group(P<0.05).Logistic analysis showed that low expression of Fas in peripheral blood T lymphocytes was an independent risk factor for incision infection after laryngeal carcinoma surgery(P<0.05).CONCLUSION Low expression of Fas in peripheral blood T lymphocytes is an independent risk factor for postoperative incision infection in patients with laryngeal carcinoma.In actual clinical treatment,the risk of postoperative infection should be evaluated according to Fas expression in peripheral blood T lymphocytes and preventive measures should be taken in time to improve the prognosis.