Correlation Between HBD1 SNP and Susceptibility to Ventilator-Associated Pneumonia and Its Outcome in Elderly Lung Cancer Patients After Thoracoscopic Radical Resection
LÜ Qian
ZHU Yifang
YANG Sanhu
LI Jingjing
ZHAO Nana
Abstract：Objective To analyze the correlation between human beta-defensin 1(HBD1)single nucleotide polymorphisms(SNP)and susceptibility to ventilator-associated pneumonia(VAP)as well as outcomes in elderly lung cancer patients after thoracoscopic radical resection of lung cancer.Methods A total of 266 elderly lung cancer patients who required ventilator support after thoracoscopic radical resection of lung cancer at Tangdu Hospital,Air Force Medical University from January 2022 to December 2024 were selected.Based on the occurrence of VAP,they were divided into a VAP group(41 cases)and a control group(225 cases).According to prognosis,the VAP group was further divided into a death group(13 cases)and a survival group(28 cases).Pathogenic bacteria and drug resistance in VAP patients were analyzed.The genotypes of SNPs in the first exon 5' non-coding region(-52A/G,-44C/G,-20A/G)of the HBD1 gene were determined by polymerase chain reaction(PCR).Logistic regression was used to analyze the relationship between SNP loci and the occurrence of VAP and prognosis in elderly lung cancer patients after radical resection.Results A total of 85 pathogenic strains were isolated from 41 VAP patients,including Gram-negative bacteria(48.24%),Gram-positive bacteria(20.00%),and fungi(31.76%).Acinetobacter baumannii showed 100%resistance to aztreonam,cefazolin,ceftriaxone,ceftazidime,sulfamethoxazole,and ampicillin.Klebsiella pneumoniae was 100%resistant to aztreonam,cefazolin,ceftriaxone,cefepime,ceftazidime,sulfamethoxazole,and ampicillin.Pseudomonas aeruginosa was 100%resistant to cefazolin,ceftriaxone,sulfamethoxazole,and ampicillin/sulbactam.Escherichia coli was 100%resistant to aztreonam,ciprofloxacin,cefazolin,ceftriaxone,cefepime,ceftazidime,levofloxacin,sulfamethoxazole,ampicillin,and ampicillin/sulbactam.The GG genotype and G allele frequency at the-44 SNP site in the 5' non-coding region of the HBD1 gene were higher in the VAP group than in the control group(P<0.05).There were no significant differences in the frequencies of the CC and CG genotypes or the corresponding C allele between the two groups(P>0.05).Multivariate logistic regression analysis showed that the GG genotype at the-44 SNP site in the 5' non-coding region of the HBD1 gene was associated with a significantly increased risk of VAP(OR=2.855,95%CI:1.347-6.083),while the CC genotype was associated with a significantly decreased risk(OR=0.440,95%CI:0.230-0.845)(P<0.05).In the VAP group,the GG genotype and G allele frequency at the-44 SNP site were higher in the death group than in the survival group(P<0.05).There were no significant differences in the frequencies of the CC and CG genotypes or the corresponding C allele between the two groups(P>0.05).Multivariate logistic regression analysis indicated that the GG genotype at the-44 SNP site was associated with a higher mortality risk(OR=4.392,95%CI:1.673-11.524),while the CC genotype was associated with a lower mortality risk(OR=0.291,95%CI:0.122-0.690)(P<0.05).Conclusions The main pathogens causing VAP in elderly lung cancer patients after thoracoscopic radical resection are Gram-negative bacteria,with high drug resistance.Antibiotics should be used rationally based on drug susceptibility testing.The SNP at the-44C/G locus of the HBD1 gene is correlated with susceptibility and prognosis of VAP.The G allele may increase the susceptibility to VAP and the risk of death in elderly lung cancer patients after thoracoscopic radical resection of lung cancer.
Keywords：lung neoplasmsthoracic surgeryvideo-assistedradical resection of lung cancerpneumoniaventilator-associatedbeta-defensin 1 single nucleotide polymorphismsusceptibilitytreatment outcome
Publication Date：2025-11-20
Online Publishing Date：2025-11-24(First online date of this platform, not the publication date of the document)
Pages：7( 11-17 )