CD64指数、sCD14、sCD163与胸腔镜肺癌根治术后并发重症肺部感染的关系研究

摘要 目的：探讨CD64指数、可溶性白细胞分化抗原14（sCD14）、可溶性白细胞分化抗原163（sCD163）与胸腔镜肺癌根治术后并发重症肺部感染的关系。方法：选择2020年1月至2023年1月南通市肿瘤医院收治的行胸腔镜肺癌根治术治疗的非小细胞肺癌（NSCLC）患者共415例。根据术后是否并发重症肺部感染将患者分为感染组（21例）和未感染组（394例）。检测外周血CD64指数和血清sCD14、sCD163水平。多因素Logistic回归分析影响胸腔镜肺癌根治术后并发重症肺部感染的因素。受试者工作特征（ROC）曲线分析CD64指数、sCD14、sCD163预测胸腔镜肺癌根治术后并发重症肺部感染的价值。结果：感染组外周血CD64指数、血清sCD14、sCD163水平高于未感染组（P＜0.05）。多因素Logistic回归分析显示高CD64指数、sCD14、sCD163、降钙素原（PCT）是胸腔镜肺癌根治术后并发重症肺部感染的危险因素（P＜0.05），高呼气峰值流量（PEF）是保护因素（P＜0.05）。CD64指数、sCD14、sCD163、PCT预测胸腔镜肺癌根治术后并发重症肺部感染的曲线下面积为0.834、0.815、0.842、0.784，联合预测曲线下面积为0.928，高于单独预测。结论：血清CD64指数、sCD14、sCD163、PCT水平升高是胸腔镜肺癌根治术后并发重症肺部感染的危险因素。联合CD64指数、sCD14、sCD163、PCT可较好地预测术后重症肺部感染的风险。

Study on the Relationship between CD64 Index, sCD14, sCD163 and Severe Pulmonary Infection after Thoracoscopic Radical Resection of Lung Cancer

ABSTRACT Objective: To investigate the relationship between CD64 index, soluble leukocyte differentiation antigen 14 (sCD14), soluble leukocyte differentiation antigen 163 (sCD163) and severe pulmonary infection after thoracoscopic radical resection of lung cancer. Methods: 415 patients with non-small cell lung cancer (NSCLC) who underwent thoracoscopic radical resection of lung cancer in Nantong Tumor Hospital from January 2020 to January 2023 were selected. Patients were divided into infection group (21 cases) and non-infection group (394 cases) according to whether severe pulmonary infection occurred after operation. Peripheral blood CD64 index and serum levels of sCD14 and sCD163 were detected. Multivariate Logistic regression analysis of the factors affecting the incidence of severe lung infection after thoracoscopic radical lung cancer surgery. The value of receiver operating characteristic (ROC) curve analysis of CD64 index, sCD14 and sCD163 in predicting severe lung infection after thoracoscopic radical lung cancer surgery. Results: The peripheral blood CD64 index, serum sCD14 and sCD163 levels in infection group were higher than those in non-infection group (P<0.05). Multivariate Logistic regression analysis showed that high CD64 index, sCD14, sCD163 and procalcitonin (PCT) were risk factors for severe pulmonary infection after thoracoscopic radical resection of lung cancer (P<0.05), and high peak expiratory flow (PEF) was a protective factor (P<0.05). The area under the curve of CD64 index, sCD14, sCD163 and PCT in predicting severe pulmonary infection after thoracoscopic radical resection of lung cancer was 0.834, 0.815, 0.842 and 0.784 respectively, the area under the curve of combined prediction was 0.928, which was higher than that of single prediction. Conclusion: The increase levels of serum CD64 index, sCD14, sCD163 and PCT are risk factors for severe pulmonary infection after thoracoscopic radical resection of lung cancer.The combination of CD64 index, sCD14, sCD163 and PCT can predict the risk of severe pulmonary infection after operation.