喉癌术后下呼吸道感染危险因素及其与Caspase-3基因多态性的关联

Risk factors for postoperative lower respiratory tract infection in laryngeal cancer patients and their association with Caspase-3 gene polymorphisms

目的分析喉癌术后下呼吸道感染危险因素及其与Caspase-3基因多态性的关联,为喉癌术后管理提供新方向。方法回顾性分析2019年1月-2021年6月重庆两江新区人民医院收治的96例喉癌术后下呼吸道感染患者为感染组,并纳入经性别、年龄1∶1匹配的96例术后未感染患者为对照组,比较两组患者Caspase-3基因rs1049216、rs12108497、rs4647693位点基因多态性,采用条件Logistic回归分析喉癌术后下呼吸道感染的危险因素。结果两组患者Caspase-3基因rs1049216、rs4647693位点基因型及基因频率比较无统计学差异;感染组Caspase-3基因rs12108497位点CC基因型及C等位基因频率高于对照组(P<0.05);两组患者性别、年龄、吸烟史、病理类型、发病部位比较无统计学差异,但两组患者肺部慢性疾病史、临床分期、手术方式比较差异有统计学意义(P<0.05);条件Logistic回归分析显示,肺部慢性疾病史、临床分期Ⅲ~Ⅳ期、喉全切术均为喉癌术后下呼吸道感染的危险因素(P<0.05)。结论Caspase-3基因rs12108497位点多态性与重庆两江新区喉癌术后下呼吸道感染易感性有关,C等位基因可能是术后下呼吸道感染的易感基因,肺部慢性疾病史,临床分期Ⅲ-Ⅳ期和喉全切均是喉癌术后下呼吸道感染的高危因素。

OBJECTIVE To analyze the Caspase-3 gene polymorphisms and risk factors for the postoperative lower respiratory tract infection in the patients with laryngeal cancer,so as to offer novel ideas for postoperative management of the laryngeal cancer patients.METHODS Totally 96 laryngeal cancer patients with postoperative lower respiratory tract infection who were treated in the People's Hospital of Chongqing Liangjiang New Area from Jan 2019 to Jun 2021 were assigned as the infection group,and 96 patients who did not have postoperative infection were matched with gender,age in a l:1 ratio and were assigned as the control group.The gene polymorphisms at rs1049216,rs12108497 and rs4647693 loci of Caspase-3 gene were compared between the two groups of patients.Conditional logistic regression analysis was performed for the risk factors for the postoperative lower respiratory tract infection.RESULTS There were no significant differences in the frequencies of genotypes and alleles at rs1049216 and rs4647693 loci of Caspase-3 gene between the two groups of patients.The frequencies of CC genotype and allele C at rs12108497 locus of Caspase-3 gene were higher in the infection group than in the control group(P<0.05).There were no significant differences in the gender,age,smoking history,pathological types and onset sites between the two groups of patients;there were significant differences in the history of chronic pulmonary disease,clinical stage and type of surgery between the two groups of patients(P<0.05).Conditional logistic regression analysis showed that the history of chronic pulmonary diseases,clinical stage Ⅲ~Ⅳ and total laryngectomy were the risk factors for the postoperative lower respiratory tract infection in the patients with laryngeal cancer(P<0.05).CONCLUSION The gene polymorphism at rs12108497 locus of Caspase-3 gene is associated with the susceptibility to the postoperative lower respiratory tract infection in the laryngeal cancer patients of Chongqing Liangjiang New Area.The C allele may be the susceptible gene for the postoperative lower respiratory tract infection.History of chronic pulmonary disease,Ⅲ~Ⅳ clinical stage and total laryngectomy are the high risk factors for the postoperative lower respiratory tract infection in the laryngeal cancer patients.