胃癌化疗PICC导管相关性血流感染对外周血T细胞亚群及TGF-β1/Smads信号通路的影响

Influence of PICC-related bloodstream infection on peripheral blood T lymphocyte subsets and TGF-β1/Smads signaling pathways of gastric cancer patients undergoing chemotherapy

目的为探讨胃癌化疗经外周静脉穿刺置人中心静脉导管(PICC)导管相关性血流感染(CRBSI)对外周血T细胞亚群及转化生长因子β1(TGF-β1)/Smads信号通路的影响。方法选择2020年10月-2023年10月黄冈市中心医院收治的胃癌化疗PICC置管患者108例为研究对象,根据患者是否发生CRBSI分为感染组31例和未感染组77例,比较两组外周血炎性因子[肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1β]、外周血T细胞亚群水平(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、TGF-β1/Smads信号通路相关蛋白及mRNA(TGF-β1、Smad3、Smad2)表达水平,采用Pearson相关分析胃癌化疗PICC置管CRBSI患者CD。+及TGF-β1蛋白与炎性因子的相关性。结果相较于未感染组患者,感染组患者TNF-α、IL-1β、CD_(8)^(+)及TGF-β1、Smad3、Smad2蛋白及mRNA表达水平均上升,而CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平均降低(P<0.05);Pearson相关分析结果显示,胃癌化疗PICC置管CRBSI患者的TGF-β1与其TNF-α及IL-1β呈正相关(P<0.05),而CD_(3)^(+)与其TNF-α及IL-1β呈负相关(P<0.05)。结论胃癌化疗PICC置管患者在发生CRBSI后会导致外周血T细胞亚群水平失调及TGF-β1/Smads信号通路被激活,影响患者的免疫状态。

OBJECTIVE To observe the influence of peripherally inserted central catheter(PICC)-related blood-stream infection(CRBSI)on peripheral blood T lymphocyte subsets and transforming growth factor-β1(TGF-β1)/signal transduction protein Smads(Smads)signaling pathways of the gastric cancer patients undergoing chemotherapy.METHODS Totally 108 gastric cancer patients who were treated with PICC and underwent chemo-therapy in Huanggang Central Hospital from Oct 2020 to Oct 2023 were recruited as the research subjects and were divided into the infection group with 31 cases and the no infection group with 77 cases according to the status of CRBSI.The levels of peripheral blood inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin(IL)-1β],peripheral blood T lymphocytes subsets(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)and CD_(4)^(+)/CD_(8)^(+))and expression levels of TGF-β1/Smads signaling pathway-related proteins and mRNA(TGF-β1,Smad3 and Smad2)were observed and compared between the two groups.Pearson correlation analysis was performed for the association between the CD_(4)^(+),TGF-βl proteins and the inflammatory factors of the gastric cancer and chemotherapy patients with CRBSI.RESULTS The levels of TNF-α,IL-1β,CD8^(+)and the expression levels of TGF-βl,Smad3,Smad2 proteins and mRNA were higher in the infection group than in the no infection group,while the levels of CD_(3)^(+)、CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)of the infection group were lower than those of the no infection group(P<0.05).The result of Pearson correlation analysis showed that the TGF-βl of the gastric cancer and chemotherapy patients with PICC-related bloodstream infection was positively correlated with TNF-αand IL-1β(P<0.05),while the CD_(3)^(+)was negatively correlated with TNF-αand IL-1β(P<0.05).CONCLUSION The PICC-related bloodstream infection may lead to the imbalance of peripheral blood T lymphocyte subsets and activation of TGF-β1/Smads signaling pathways of the gastric cancer patients undergoing chemotherapy and affect the immune state of the patients.