Association between matrix metallopeptidase-9 rs3918242 locus single nucleotide polymorphisms and intra-abdominal infection after pancreaticoduodenectomy

Chen Dawei; Tang Xiaodong; Chen Sheng; Zhao Zhenguo; Deng Zhicheng; Jia Jingchao; Zhou Biao; Liu Shuanghai

doi:10.3760/cma.j.issn.1001-9030.2017.12.070

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• 临床研究 •

基质金属蛋白酶-9 rs3918242位点单核苷酸多态性与胰十二指肠切除术后腹腔感染的关系

中华实验外科杂志, 2017,34(12) : 2230-2233. DOI: 10.3760/cma.j.issn.1001-9030.2017.12.070

摘要

目的

探讨基质金属蛋白酶-9(MMP-9) rs3918242位点单核苷酸多态性与胰十二指肠切除术后腹腔感染的关系。

方法

纳入152例行胰十二指肠切除术患者，采用Logistic回归方法分析MMP-9 rs3918242多态性在内的21个因素与胰十二指肠切除术后腹腔感染的关系，并比较不同组别患者术后血浆MMP-9浓度差异。

结果

单因素分析提示胰管直径≥3 mm[比值比(OR)＝0.378，95%可信区间(CI)：0.163，0.874，P＝0.023]、胰腺质地软(OR＝3.414，95%CI：1.353，8.612，P＝0.009)、手术时间≥6 h(OR＝3.018，95%CI：1.302，6.991，P＝0.010)、胰瘘(OR＝6.615，95%CI：2.708，16.161，P＝0.000)、术后腹腔出血(OR＝8.768，95%CI：1.958，39.264，P＝0.005)和rs3918242多态性(CT/TT基因型，OR＝0.211，95%CI：0.060，0.737，P＝0.015)与胰十二指肠切除术后腹腔感染相关。多因素分析结果提示手术时间≥6 h(OR＝4.181，95%CI：1.535，11.384，P＝0.005)，胰瘘(OR＝9.713，95%CI：3.507，26.900，P＝0.000)和rs3918242多态性(CT/TT基因型，OR＝0.166，95%CI：0.042，0.646，P＝0.010)与胰十二指肠切除术后腹腔感染相关。rs3918242 CT/TT基因型患者术后血浆MMP-9浓度为(275.2±103.9) ng/ml显著高于CC基因型患者[(240.1±85.2) ng/ml，P＝0.005]，腹腔感染患者术后血浆MMP-9浓度为(205.6±83.1) ng/ml显著低于未腹腔感染患者[(258.5±82.4) ng/ml，P＝0.000]。

结论

手术时间、胰瘘和MMP-9 rs3918242多态性是胰十二指肠切除术后腹腔感染的独立影响因素，术后较低血浆MMP-9浓度易造成腹腔感染。

引用本文: 陈达伟, 汤晓东, 陈胜, 等. 基质金属蛋白酶-9 rs3918242位点单核苷酸多态性与胰十二指肠切除术后腹腔感染的关系 [J] . 中华实验外科杂志,2017,34 (12): 2230-2233. DOI: 10.3760/cma.j.issn.1001-9030.2017.12.070

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未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。

除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。

基质金属蛋白酶-9(MMP-9)由中性粒细胞、单核细胞和淋巴细胞等分泌，可调节细胞因子和趋化因子活性，在免疫应答中起重要作用^[1]。rs3918242为MMP-9基因启动子区功能性单核苷酸多态性(SNP)位点，可调控MMP-9基因转录活性^[2]。本研究旨在探讨MMP-9 rs3918242位点单核苷酸多态性与胰十二指肠切除术后腹腔感染的关系。

贡献者信息

陈达伟

214400　江阴，东南大学医学院附属江阴医院肝胆胰外科

汤晓东

214400　江阴，东南大学医学院附属江阴医院肝胆胰外科

陈胜

214400　江阴，东南大学医学院附属江阴医院肝胆胰外科

赵振国

214400　江阴，东南大学医学院附属江阴医院肝胆胰外科

邓志成

214400　江阴，东南大学医学院附属江阴医院肝胆胰外科

贾竞超

214400　江阴，东南大学医学院附属江阴医院肝胆胰外科

周标

214400　江阴，东南大学医学院附属江阴医院肝胆胰外科

刘双海

214400　江阴，东南大学医学院附属江阴医院肝胆胰外科

通信作者

刘双海

214400　江阴，东南大学医学院附属江阴医院肝胆胰外科

Email：shuanghaimed@yeah.net

关键词

基质金属蛋白酶-9; 单核苷酸多态性; 腹腔感染; 胰十二指肠切除术; 胰瘘;

基金项目

江苏省人才工作领导小组办公室"双创博士"项目（201526）

无锡市卫生和计划生育委员会青年卫生科研项目（Q201622）

历史

出版日期：2017-12-08

收稿日期：2017-03-22

Clinical Research

Association between matrix metallopeptidase-9 rs3918242 locus single nucleotide polymorphisms and intra-abdominal infection after pancreaticoduodenectomy

Chen Dawei, Tang Xiaodong, Chen Sheng, Zhao Zhenguo, Deng Zhicheng, Jia Jingchao, Zhou Biao, Liu Shuanghai

Published 2017-12-08

Cite as Chin J Exp Surg, 2017,34(12): 2230-2233. DOI: 10.3760/cma.j.issn.1001-9030.2017.12.070

Abstract

Objective

To investigate the association between matrix metallopeptidase-9 (MMP-9) rs3918242 locus single nucleotide polymorphisms and intra-abdominal infection after pancreaticoduodenectomy.

Methods

152 patients undergoing pancreaticoduodenectomy were enrolled, and the association between 21 factors including MMP-9 rs3918242 polymorphisms and intra-abdominal infection after pancreaticoduodenectomy was analyzed using Logistic regression method. Postoperative plasma MMP-9 levels were compared between different groups.

Results

Univariate analysis revealed pancreatic duct diameter ≥3 mm [odds ratio (OR)=0.378, 95% confidence interval (CI): 0.163, 0.874, P=0.023], pancreatic texture (soft, OR=3.414, 95% CI: 1.353, 8.612, P=0.009), operative time ≥6 h (OR=3.018, 95% CI: 1.302, 6.991, P=0.010), pancreatic fistula (OR=6.615, 95% CI: 2.708, 16.161, P=0.000), postoperative intra-abdominal bleeding (OR=8.768, 95% CI: 1.958, 39.264, P=0.005), and rs3918242 polymorphisms CT/TT genotypes (OR=0.211, 95% CI: 0.060, 0.737, P=0.015) were associated with intra-abdominal infection after pancreaticoduodenectomy. Operative time ≥6 h (OR=4.181, 95% CI: 1.535, 11.384, P=0.005), pancreatic fistula (OR=9.713, 95% CI: 3.507, 26.900, P=0.000), and rs3918242 polymorphisms CT/TT genotypes (OR=0.166, 95% CI: 0.042, 0.646, P=0.010) were associated with intra-abdominal infection after pancreaticoduodenectomy in multivariate analysis. The patients carrying rs3918242 CT/TT genotypes [(275.2±103.9) ng/ml] had higher postoperative plasma MMP-9 levels than those carrying CC genotype [(240.1±85.2) ng/ml, P=0.005]. Meanwhile, the patients with intra-abdominal infection [(205.6±83.1) ng/ml] had lower postoperative plasma MMP-9 levels than those without intra-abdominal infection [(258.5±82.4) ng/ml, P=0.000].

Conclusion

Operative time, pancreatic fistula, and rs3918242 polymorphisms were the independent influential factors of intra-abdominal infection after pancreaticoduodenectomy. Lower postoperative plasma MMP-9 levels may contribute to the development of intra-abdominal infection.

Key words:

Matrix metalloproteinase-9; Single nucleotide polymorphisms; Intra-abdominal infection; Pancreaticoduodenectomy; Pancreatic fistula

Contributor Information

Chen Dawei

Department of Hepatopancreatobiliary Surgery, Jiangyin People’s Hospital, School of Medicine, Southeast University, Jiangyin 214400, China

Tang Xiaodong

Chen Sheng

Zhao Zhenguo

Deng Zhicheng

Jia Jingchao

Zhou Biao

Liu Shuanghai

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