The relationship between microRNA-155-5p and postoperative inflammatory markers in children with acute suppurative appendicitis and its role in predicting postoperative complications.
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BACKGROUND: The prevalence of acute suppurative appendicitis (ASA) is the highest among pediatric cases of acute abdominal conditions. This research examined the stress response linked to surgical techniques and identified potential biomarkers that could predict postoperative complications to enhance clinical treatment strategies. METHODS: This study involved a selection of 166 ASA patients who underwent laparoscopic appendectomy (LA), and 150 patients who underwent open appendectomy (OA), based on data collected from 2020 to 2023. Comprehensive documentation of clinical and pathological characteristics, as well as postoperative complications, was conducted following patient enrollment. Quantitative polymerase chain reaction (qPCR), enzyme-linked immunosorbent assay (ELISA), and blood smear techniques were employed to assess the levels of microRNA (miR)-155-5p, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), superoxide dismutase (SOD), and malondialdehyde (MDA), as well as changes in leukocytes, neutrophils, and lymphocytes at preoperative and postoperative 0 h, and 24 h. A logistic regression model was utilized to identify risk factors associated with the development of complications. Furthermore, receiver operating characteristic (ROC) curve analysis was performed to assess the predictive capacity of miR-155-5p for the occurrence of complications. RESULTS: The study revealed that the levels of miR-155-5p postoperatively in patients undergoing OA was significantly greater than that observed in patients undergoing LA (P<0.001). The expression levels of miR-155-5p exhibited a significant positive correlation with inflammatory markers (CRP, r=0.546; IL-6, r=0.628; TNF-α, r=0.808; leukocytes, r=0.778; neutrophils, r=0.718; and lymphocytes, r=0.820), indicators of oxidative stress (SOD, r=0.671; and MDA, r=0.489), and visual analog scale (VAS, r=0.671) scores (P<0.001). Furthermore, miR-155-5p might influence the concentrations of inflammatory and oxidative stress markers in the serum of patients both preoperatively and postoperatively (P<0.05). Notably, miR-155-5p was identified as risk factors for the development of postoperative complications (OR=8.331, P=0.008) and had a high predictive value for the occurrence of postoperative complications (area under the curve=0.926, P<0.001). CONCLUSION: miR-155-5p might play a role in modulating the body’s stress response, subsequently impacting the postoperative complications incidence of ASA patients.