Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
PLoS One. 2024 Mar 14;19(3):e0297742. doi: 10.1371/journal.pone.0297742. eCollection 2024.
Chronic postsurgical pain may have a substantial impact on patient's quality of life, and has highly heterogenous presentation amongst sufferers. We aimed to explore the risk factors relating to chronic pain and the related miRNA phenotypes in patients with lung adenocarcinoma after video-assisted thoracoscopic lobectomy to identify potential biomarkers. Our prospective study involved a total of 289 patients with early invasive adenocarcinoma undergoing thoracoscopic lobotomy and a follow-up period of 3 months after surgery. Blood was collected the day before surgery for miRNA detection and patient information including operation duration, duration of continuous drainage of the chest, leukocyte count before and after operation, and postoperative pain scores were recorded. Using clinical and biochemical information for each patient, the risk factors for chronic postsurgical pain and related miRNA phenotypes were screened. We found that chronic postsurgical pain was associated with higher body mass index; greater preoperative history of chronic pain; longer postoperative drainage tube retention duration; higher numerical rating scale scores one, two, and three days after surgery; and changes in miRNA expression, namely lower expression of miRNA 146a-3p and higher expression of miRNA 550a-3p and miRNA 3613-3p in peripheral blood (p < 0.05). Of these factors, patient body mass index, preoperative history of chronic pain, average numerical rating scale score after operation, and preoperative peripheral blood miRNA 550a-3P expression were independent risk factors for the development of chronic postsurgical pain. Identification of individual risk markers may aid the development and selection of appropriate preventive and control measures.
慢性术后疼痛可能对患者的生活质量产生重大影响，且在患者中表现出高度异质性。我们旨在探讨与肺腺癌患者电视辅助胸腔镜肺叶切除术后慢性疼痛相关的危险因素和相关 miRNA 表型，以确定潜在的生物标志物。我们的前瞻性研究共纳入 289 例早期浸润性腺癌患者，均接受电视辅助胸腔镜肺叶切除术，术后随访 3 个月。手术前一天采集血液进行 miRNA 检测，并记录患者信息，包括手术时间、胸腔引流管持续时间、手术前后白细胞计数和术后疼痛评分。利用每位患者的临床和生化信息，筛选慢性术后疼痛的危险因素和相关 miRNA 表型。我们发现，慢性术后疼痛与较高的体重指数、术前慢性疼痛史、术后引流管保留时间较长、术后 1、2、3 天数字评分量表评分较高以及外周血 miRNA 表达改变有关，即 miRNA 146a-3p 表达降低和 miRNA 550a-3p、miRNA 3613-3p 表达升高（p<0.05）。这些因素中，患者体重指数、术前慢性疼痛史、术后平均数字评分量表评分和术前外周血 miRNA 550a-3P 表达是慢性术后疼痛发展的独立危险因素。识别个体风险标志物可能有助于制定和选择适当的预防和控制措施。
