Risk factors for postoperative oral infection and activation status of TLR4/NF-κB of patients with oral squamous cell carcinoma
OBJECTIVE To explore the prevalence of postoperative oral infection,risk factors and expressions of Toll-like receptor 4(TLR4)/nuclear transcription factor-κB(NF-κB)signaling pathways in the patients with oral squamous cell carcinoma(OSCC).METHODS Totally 116 patients with OSCC who were treated in Huzhou First People's Hospital from Jan 2018 to Dec 2022 were enrolled in the study and were divided in to the infection group with 32 cases and the non-infection group with 84 cases according to the status of postoperative oral infection.The distribution of pathogens was statistically analyzed,multivariate logistic regression analysis was performed for the risk factors for the postoperative oral infection,and the expression levels of TLR4/NF-κB signaling pathway-relat-ed factors were compared between the two groups.RESULTS Of the 116 patients with OSCC,32 had postopera-tive oral infection,with the incidence of oral infection 27.59％.Totally 33 strains of pathogens were isolated from the infection group,12(36.36％)of which were gram-negative bacteria,21(63.64％)were gram-positive bacte-ria.The result of multivariate logistic analysis showed that operation duration no less than 6 hours,diabetes melli tus and prophylactic use of antibiotics were the risk factors for the postoperative oral infection in the OSCC pa-tients(OR=2.282,2.117,2.416,P＜0.05).The expression levels of serum IL-6,TNF-α and relative expres-sion levels of TLR4 and NF-κB mRNA were significantly higher in the infection group than in the non-infection group(P＜0.05).CONCLUSION The gram-positive bacteria are dominant among the pathogens isolated from the OS-CC patients with postoperative oral infection.The postoperative oral infection in the OSCC patients is closely associated with the operation duration no less than 6 hours,diabetes mellitus and prophylactic use of antibiotics,and the patients with postoperative oral infection show the upregulation of TLR4/NF-κB signaling pathway-related factors.
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