基于mRNA生物信息学分析的肺腺癌免疫基因预后风险模型建立与评估

目的采用生物信息学方法构建并验证肺腺癌免疫基因预后风险模型,探究该模型对早期肺腺癌患者预后的预测潜力。方法将癌症基因组图谱(The Cancer Genome Atlas,TCGA)来源的肺腺癌及正常组织数据作为训练集,将基因表达综合数据库(Gene Expression Omnibus,GEO)来源的肺腺癌及正常组织数据作为测试集。根据免疫学数据库和分析平台(Immunology Database and Analysis Portal,ImmPort)中提供的免疫相关基因,利用生物信息学手段根据训练集数据建立预后风险模型并在测试集中进行外部验证。采用该模型对38例临床早期肺腺癌患者的转录组数据进行分析,评估高、低危组患者的临床病理参数差异。结果构建了包含12个差异表达免疫基因(CYBB、ARG2、UTS2、LIFR、SHC3、CTLA4、FGF2、SEMA7A、INHA、GPI、ANGPTL4、TNFRSF11A)的肺腺癌预后风险模型;在训练集中,该模型ROC曲线下面积(AUC~(ROC))为0.759;在测试集中,AUC~(ROC)为0.707。对于训练集及测试集中的早期肺腺癌患者,该模型也有良好的预后预测能力。在早期肺腺癌临床样本中,高风险患者与更大的肿瘤直径及更差的病理分型有关。结论该模型在训练集及测试集中都表现出良好的预后预测能力,并对临床早期肺腺癌患者预后有一定的提示作用。这些免疫基因能够为早期肺腺癌诊断、患者预后评估及新的治疗靶点研究提供方向。

Epidemiological investigation of three clinically isolated carbapenem-resistant strains of OXA-232-producing Klebsiella pneumoniae

Objective To investigate the clinical epidemiological characteristics of OXA-232-producing Klebsiella pneumoniae (OXA-232Kp). Methods The clinical isolates of carbapenem-resistant Klebsiella pneumoniae (CRKP) from 5 hospitals in Jiangsu province during September 2018 and September 2019 were collected, and their drug susceptibility were analyzed by the microbroth dilution method and Phoenix-M50 automatic microbiological system. The blaOXA-232 gene was detected by PCR and sequencing. The homology of the strains was analyzed by the pulsed field gel electrophoresis (PFGE). The surrounding environment of the plasmid carrying blaOXA-232 gene was analyzed by the plasmid sequencing. Results Three strains of OXA-232Kp ST15 were screened. PFGE analysis showed that they were clonal transmission, and carried the 6 141 bp ColKP3 plasmid, which was highly homologous with the plasmid carrying the blaOXA-232 gene found in eastern China. Conclusion This is the first time to investigate the epidemiological characteristics of OXA-232Kp ST15 in Jiangsu province. The high homology of the plasmid carrying blaOXA-232 indicates that the 6 141 bp ColE type plasmid plays an important role in the prevalence of OXA-232 in Jiangsu region.