Association of the degree of disease and prognosis of patients with acute necrotizing pancreatitis infection with miR-25 and TRAIL
OBJECTIVE To explore the association of the degree of disease and prognosis of patients with acute ne-crotizing pancreatitis(ANP)infection with peripheral blood microRNA-25(miR-25)and tumor necrosis factor-re-lated apoptosis-inducing ligand(TRAIL).METHODS A total of 83 patients with ANP infection admitted to Jinhua Central Hospital between Jan.2020 and Mar.2023 were selected and were divided into mild group(24 cases),moderate group(31 cases)and severe group(28 cases)according to disease severity,and they were further divid-ed into good prognosis group(61 cases)and poor prognosis group(22 cases)according to survival status within 28d of follow-up.The pancreatic necrosis tissues or drainage specimens were collected aseptically for isolation and identification of pathogens.The levels of peripheral blood miR-25,TRAIL and tumor necrosis factor-α(TNF-α),and scores of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)in patients with different disease se-verity were compared.The relationship between serum miR-25,TRAIL,TNF-α and APACHEⅡ scores was ana-lyzed by Pearson correlation analysis.The clinical characteristics,levels of peripheral blood miR-25,TRAIL and TNF-α were compared between poor prognosis group and good prognosis group.The evaluation value of peripheral blood miR-25 in assessing the prognosis of patients with ANP comorbidities was analyzed by receiver operating characteristic(ROC)curves.RESULTS There were 98 strains of pathogens in patients with ANP infection,which were mainly of Escherichia coli,Klebsiella pneumoniae and Enterococcus faecium.The levels of peripheral blood miR-25 and TRAIL in severe groups were(0.21±0.05)and(49.31±12.78)pg/ml,lower than those in moderate group and mild group,while TNF-α level and APACHE Ⅱ score were(36.49±6.02)pg/ml and(24.15±6.79)points,respectively higher than those in moderate group and mild group(P＜0.05).The levels of miR-25 and TRAIL were negative correlated with APACHE Ⅱ scores(r=-0.587,-0.548,P all＜0.05),while TNF-αwas positively correlated with APACHE Ⅱ scores(r=0.506,P＜0.001).The levels of peripheral blood miR-25 and TRAIL in poor prognosis group were(0.23±0.09)and(55.17±4.26)pg/ml,lower than those in good prognosis group,while TNF-α level was(36.79±6.44)pg/ml,higher than that in prognosis group group(P＜0.05).The area under the curve(AUC)of miR-25 for predicting poor prognosis were 0.837,with the cut-off value of 0.24(P＜0.05).CONCLUSION The levels of peripheral blood miR-25 and TRAIL were negatively correlated with disease severity in patients with ANP infection,and the miR-25 could be applied as a reliable evaluation index for prognosis.
Acute necrotizing pancreatitisInfectionMicro RNA-25Tumor necrosis factor-related apoptosis-in-ducing ligandDisease severityPrognosisCorrelationPredictive value
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