不同标本中MyD88通路分子预测HBV感染相关肝癌术后病毒再活化的诊断分析

Diagnostic analysis of MyD88 pathway molecules in different specimens for predicting viral reactivation after HBV infection-related liver cancer surgery

目的:探讨不同标本中髓样分化因子88(MyD88)通路分子预测乙型肝炎病毒(HBV)感染相关肝癌术后病毒再活化的价值,为预测患者术后病毒再活化风险及精准识别高风险人群提供参考并指导临床靶向干预。方法:选取2017年1月至2021年1月信阳一五四医院收治的82例接受手术治疗的HBV感染相关肝癌患者,根据术后1个月病毒是否再活化分为再活化组、未再活化组,比较两组肝癌组织MyD88通路分子MyD88、白介素-1受体相关激酶1(IRAK1)、肿瘤坏死因子受体相关因子6(TRAF6)、转化生长因子-β激活激酶1(TAK1)、干扰素调节因子7(IRF7)mRNA表达、外周血单个核细胞(PBMCs)、浆细胞样树突状细胞(pDCs)数及PBMCs和pDCs中MyD88通路分子表达,采用受试者工作特征曲线(ROC)及曲线下面积(AUC)分析不同标本中MyD88通路分子预测术后病毒再活化的价值。结果:两组肝癌组织中MyD88、IRAK1、TRAF6、TAK1、IRF7mRNA表达差异无统计学意义(P>0.05)。两组术前、术后外周血PBMCs、pDCs数差异无统计学意义(P>0.05);再活化组术前、术后PBMCs、pDCs中MyD88、IRF7 mRNA低于未再活化组(P<0.05);两组术前、术后PBMCs与pDCs中IRAK1、TRAF6、TAK1mRNA表达差异无统计学意义(P>0.05);术后pDCs中MyD88 mRNA联合IRF7 mRNA的AUC大于术后PBMCs中二者联合的AUC。结论:PBMCs与pDCs中MyD88、IRF7 mRNA与HBV感染相关肝癌术后病毒再活化有关,二者联合可为临床预测病毒再活化提供参考。

Objective:To investigate value of myeloid differentiation factor 88(MyD88)pathway molecules in different specimens in predicting viral reactivation after hepatitis B virus(HBV)infection-related hepatocellular carcinoma,to predict risk of postoperative viral reactivation and accurately identify high-risk patients for clinicians and to guide clinical targeted intervention.Methods:A total of 82 patients with liver cancer related to HBV infection who were admitted in Xinyang 154 Hospital from January 2017 to January 2021 were divided into reactivated group and non-reactivated group according to whether virus was reactivated one month after operation,and MyD88 pathway molecules MyD88,interleukin-1 receptor related kinase 1(IRAK1),tumor necrosis factor receptor related factor 6(TRAF6),transforming growth factor-βactivated kinase 1(TAK1),interferon regulatory factor 7(IRF7)mRNA expressions in liver cancer tissues,numbers of peripheral blood mononuclear cells(PBMCs),plasmacytoid dendritic cells(pDCs),MyD88 pathway molecules experissions in PBMCs and pDCs of two groups were compared.Receiver operating characteristic curves(ROC)and area under ROC(AUC)were used to analyze value of MyD88 pathway molecules in different specimens to predict postoperative viral reactivation.Results:There was no significant difference in expressions of MyD88,IRAK1,TRAF6,TAK1,IRF7 mRNA in two groups of liver cancer tissues(P>0.05);numbers of PBMCs and pDCs in peripheral blood before and after operation has no significant difference between two groups(P>0.05);MyD88 and IRF7 mRNA in PBMCs and pDCs before and after operation in reactivation group were lower than non-reactivation group(P<0.05);IRAK1,TRAF6,TAK1 mRNA in PBMCs and pDCs before and after operation in two groups had no significant difference before and after operation(P>0.05).AUC of MyD88 mRNA combined with IRF7 mRNA in postoperative pDCs was greater than that in postoperative PBMCs.Conclusion:MyD88 and IRF7 mRNA in PBMCs and pDCs are related to viral reactivation after HBV infection-related liver cancer surgery,whose combination detection can provide a reference for clinical prediction of viral reactivation.