Risk factors for pulmonary infection in elderly patients with lung cancer undergoing chemoradiotherapy and association with FOXO3A gene polymorphisms
OBJECTIVE To explore the risk factors for pulmonary infection in the elderly patients with lung cancer(LC)who underwent chemoradiotherapy and analyze the association with polymorphisms of specific loci of fork-head box O transcription factor 3A(FOXO3A)gene.METHODS Totally 213 elderly patients with LC who were treated in the First Affiliated Hospital of Nanyang Medical College from Jun 2020 to Jun 2023 were enrolled in the study and were divided into the infection group with 47 cases and the non-infection group with 166 cases according to the status of pulmonary infection during the treatment period.The distribution of pathogens was observed,the polymorphisms at rs12212067 locus of FOXO3A gene were detected.Multivariate logistic stepwise regression a-nalysis was performed for the risk factors for the pulmonary infection during the chemoradiotherapy.RESULTS Totally 56 strains of pathogens were isolated from the 47 patients with infection,35(62.50％)of which were gram-negative bacteria.The frequencies of TT,TC genotypes and T allele at rs12212067 locus of FOXO3A gene were higher in the infection group than in the non-infection group(P＜0.05).The proportions of patients with age,history of diabetes mellitus,stage Ⅳ of TNM,radiotherapy or(and)chemotherapy,cycle of chemotherapy more than 4 cycles,and without prophylactic use of antibiotics were higher in the infection group than in the non-infection group(P＜0.05).Multivariate logistic stepwise regression analysis showed that the age and cycle of chemotherapy were the risk factors for the pulmonary infection in the elderly patients with LC undergoing chemo-radiotherapy(P＜0.05),and the prophylactic use of antibiotics was the protective factor(P＜0.05).CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the elderly LC patients undergoing chemoradiotherapy.The TT genotype at rs12212067 locus of FOXO3A gene is the risk genotype for the pulmonary infection.The age and cycle of chemotherapy are the risk factors for the pulmonary infection during the chemoradiotherapy,and the prophylactic use of antibiotics is the protective factor.
Lung cancerRadiotherapyChemotherapyForkhead box O transcription factor 3AGene polymor-phismLung functionRisk factor
万方数据
维普
