血清PCT、CRP与sTREM-1在肺癌患者术后肺部感染中表达及其诊断价值分析

目的:探究血清降钙素原(PCT)、C-反应蛋白(CRP)与可溶性人髓系细胞触发受体-1(sTREM-1)在肺癌患者术后肺部感染中表达及其诊断价值。方法:选择2016年2月至2019年10月期间在我院行肺癌根治术的420例肺癌患者作为研究对象,根据术后患者是否发生肺部感染进一步划分为380例未感染组和40例感染组。感染组根据治疗结局进一步划分为29例治疗好转亚组与11例未好转亚组。采用酶联免疫吸附法检测各组的血清PCT、CRP与s TREM-1水平,采用受试者工作特征(ROC)曲线分析血清PCT、CRP和s TREM-1对肺癌患者术后肺部感染的预测价值。结果:与未感染组相比,感染组手术后血清PCT、CRP和s TREM-1水平均明显升高(P0.05)。与治疗好转亚组相比较,治疗未好转亚组手术后以及感染后血清PCT、CRP和s TREM-1水平均明显升高(P0.05)。ROC曲线显示,PCT的曲线下面积(AUC)为0.713,最佳截断值为1.23 ng/mL,灵敏度、特异度分别为0.81、0.79,准确度为0.82;CRP的AUC为0.752,最佳截断值为36.07 mg/L,灵敏度、特异度分别为0.83、0.81,准确度为0.83;s TREM-1的AUC为0.792,最佳截断值为20.58 pg/mL,灵敏度、特异度分别为0.86、0.84,准确度为0.85;PCT、CRP联合s TREM-1预测肺癌患者术后肺部感染的AUC为0.884,灵敏度、特异度分别为0.89、0.91,准确度为0.92。结论:肺癌根治术后肺部感染发生与患者血清PCT、CRP和s TREM-1水平相关,早期联合检测血清PCT、CRP和s TREM-1有助于预测肺癌根治术患者肺部感染发生风险,在肺癌根治术后肺部感染的预测和诊断中具有一定临床价值。

Expression of Serum PCT, CRP and sTREM-1 in Patients with Lung Cancer and Its Diagnostic Value

ABSTRACT Objective: To investigate the expression and diagnostic value of serum Procalcitonin (PCT), C-reactive protein (CRP) and Soluble human myeloid cell trigger receptor-1 (strom-1) in postoperative pulmonary infection in patients with lung cancer. Methods: 420 cases of lung cancer patients who underwent radical resection of lung cancer in our hospital from February 2016 to October 2019 were selected as the study subjects. According to whether or not pulmonary infection occurred after the surgery, the patients were further divided into 380 cases of uninfected group and 40 cases of infected group. The infection group was further divided into 29 cases improved subgroup and 11 cases not improved subgroup according to treatment outcome. Serum PCT, CRP and sTREM-1 levels in each group were detected by ELISA, and the predictive value of PCT, CRP and sTREM-1 on postoperative pulmonary infection in lung cancer patients was analyzed by ROC curve. Results: Compared with the uninfected group, serum PCT, CRP and sTREM-1 levels in the infected group were significantly increased after surgery(all P<0.05). Serum PCT, CRP and sTREM-1 levels were significantly increased in the unimproved subgroup after surgery and after infection (all P<0.05). ROC curve shows that the AUC of PCT was 0.713, the best cutoff value was 1.23 ng/mL, the sensitivity and specificity were 0.81, 0.79, and the accuracy was 0.82. the AUC of CRP was 0.752, the best cutoff value was 36.07 mg/L, the sensitivity and specificity were 0.83, 0.81, and the accuracy was 0.83. the AUC of strom-1 was 0.792, the best cutoff value was 20.58 pg/mL, the sensitivity and specificity were 0.86, 0.84, respectively. The accuracy was 0.85, the AUC of PCT and CRP combined with srem-1 was 0.884, the sensitivity and specificity were 0.89 and 0.91 respectively, and the accuracy was 0.92. Conclusion: The occurrence of pulmonary infection after radical resection of lung cancer is related to serum PCT, CRP and sTREM-1 levels. Early combined detection of serum PCT, CRP and sTREM-1 can help predict the risk of pulmonary infection in patients undergoing radical resection of lung cancer, and has certain clinical value in the prediction and diagnosis of pulmonary infection after radical resection of lung cancer.