Types of miRNAs.

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.

慢性术后痛（Chronic Postsurgical Pain）可对患者的生活质量造成显著影响，且不同患者的临床表现具有高度异质性。本研究旨在探究胸腔镜辅助肺叶切除术（video-assisted thoracoscopic lobectomy）后肺腺癌患者发生慢性术后痛的相关危险因素及微小核糖核酸（microRNA, miRNA）表型，以筛选潜在的生物标志物。本前瞻性研究共纳入289例接受胸腔镜肺叶切除术的早期浸润性腺癌患者，术后随访时长为3个月。术前一日采集血液样本用于miRNA检测，并记录患者的手术时长、胸腔持续引流时长、手术前后白细胞计数以及术后疼痛评分等临床信息。基于每位患者的临床与生化信息，筛选慢性术后痛的危险因素及相关miRNA表型。研究结果显示，慢性术后痛与更高的体质量指数、术前慢性疼痛病史、术后引流管留置时长更长、术后第1、2、3日的数字疼痛评分量表（Numerical Rating Scale, NRS）评分更高，以及外周血miRNA表达改变相关：具体为外周血中miRNA 146a-3p表达下调，而miRNA 550a-3p与miRNA 3613-3p表达上调（p < 0.05）。上述因素中，患者体质量指数、术前慢性疼痛病史、术后平均数字疼痛评分量表评分以及术前外周血miRNA 550a-3p表达水平均为慢性术后痛发生的独立危险因素。筛选个体风险标志物有助于开发并选用适宜的慢性术后痛预防与控制策略。