Pathogenic bacteria and monocyte CD36/mTORC1 pathway in patients with abdominal infection after interventional therapy for metastatic hepatocellular carcinoma
OBJECTIVE To explore the pathogenic bacteria and the changes of monocyte cluster of differentiation 36(CD36)/mammalian target of rapamycin C1(mTORC1)pathway in patients with abdominal infection after inter-ventional therapy for metastatic hepatocellular carcinoma(MHC).METHODS Totally 98 patients with MHC who underwent transcatheter arterial chemoembolization(TACE)interventional therapy in Ganzhou People's Hospital were selected from Jun.2022 to Jun.2023,15 patients with postoperative abdominal infection were included in the infection group,and 83 patients without abdominal infection were enrolled as the non-infection group.The distri-bution of pathogenic bacteria in the infection group was analyzed,the levels of CD36,CD8,CRP,IL-8,and mTORC1 in the infected group were detected by flow cytometry,serum C-reactive protein(CRP)and interleukin-8(IL-8)levels were detected by enzyme-linked immunosorbent assay,and mTORC1 expression in peripheral blood was measured by protein blotting.Multivariate logistic regression was used to analyzed the risk factors for abdominal cavity infections after MHC interventions.Receiver operating characteristic curve(ROC)was adopted to evaluate the predictive value of CD36/mTORC1 pathway for abdominal cavity infection.RESULTS A total of 23 strains of pathogenic bacteria were co-cultured and isolated from the abdominal drainage fluid samples of 15 pa-tients with abdominal infection,of which 12 strains of gram-negative bacteria accounted for 52.17％ ,10 strains of gram-positive bacteria accounted for 43.48％ and 1 strain of fungus accounted for 4.35％ .The CD36,CD8,CRP,IL-8 and mTORC1 in infection group were(84.65±8.12)％ ,(28.04±5.17)％ ,(16.36±4.42)mg/L,(164.72±35.26)pg/ml,and 1.72±0.23,respectively,higher than those in the uninfected group,while CD4 was(29.46±4.83)％ ,lower than those in the uninfected group(P＜0.05).The combination of diabetes mellitus(OR=1.667)and CD36(OR=1.667),and mTORC1(OR=2.743)were the risk factors of abdominal cavity infection in MHC patients after TACE(P＜0.05).ROC curve revealed that the AUC of combined prediction of CD36 and mTORC1 was 0.916,which was better than that of single detection of 0.768 or 0.814(P＜0.05).CONCLUSIONS Gram-neg-ative bacteria were the main pathogenic bacteria of abdominal infection after TACE in MHC patients.Peripheral blood CD36 and mTORC1 were highly expressed in patients with infection,and were risk factors for infection.Therefore,combined detection of CD36 and mTORC1 was helpful for clinical assessment of abdominal cavity in-fection in patients as early as possible.
Metastatic hepatic carcinomaTranshepatic arterial chemoembolizationAbdominal infectionPatho-genic bacteriaRisk factorCluster of differentiation 36Mammalian target of rapamycin C1Diagnostic value
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