肺癌合并感染患者肿瘤坏死因子-α、超敏C反应蛋白和白细胞介素-8水平变化与肺部感染的关系

Relationship between plasma levels of tumor necrosis factor-α,hypersensitive C-reactive protein and interlukin-8 in patients with lung infection after lung cancer surgery and respiratory infection

目的探讨肺癌合并感染患者肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-8(IL-8)水平变化与肺部感染的关系。方法选取2022年6月至2022年11月郑州大学附属肿瘤医院收治的61例肺癌患者作为研究对象, 根据是否出现肺部感染, 分为感染组(31例)和对照组(30例)。采用酶联免疫吸附试验(ELISA)和放射免疫法检测两组患者血清中TNF-α、hs-CRP、IL-8水平变化。通过相关性分析以及Logistic回归分析筛选肺部感染的危险因素, 并通过受试者工作曲线(ROC)对预测价值进行评估。结果对照组患者血清TNF-α、IL-8和hs-CRP水平[(14.97±2.73)、(25.83±5.68)、(27.57±4.91) pg/ml]明显低于感染组患者[(35.81±6.93)、(52.26±8.78)、(50.55±10.03) pg/ml], 差异有统计学意义(t=15.360、13.900、10.030, P<0.05)。性别、年龄、体质量指数、病理类型、分期、合并症、吸烟室和饮酒史等指标与肺部感染无相关性, 而TNF-α、hs-CRP、IL-8水平与肺部感染呈正相关。Logistic回归分析显示TNF-α[Wald χ^(2)=8.145, P<0.05, 风险比(HR)=1.214, 95%可信区间(CI):0.614~0.924]、hs-CRP(Wald χ^(2)=5.254, P<0.05, HR=1.021, 95%CI:0.254~0.812)、IL-8(Wald χ^(2)=4.598, P<0.05, HR=0.947, 95%CI:0.987~1.211)水平是肺癌患者肺部感染的独立危险因素。ROC曲线分析显示TNF-α、hs-CRP、IL-8预测肺癌患者肺部感染的效能较高, 三者联合预测价值更高(AUC=0.918, 95%可信区间:0.896~0.974)。结论肺癌患者肺部感染后血清TNF-α、IL-8和hs-CRP水平明显增加, 是肺部感染的独立危险因素, 对肺部感染预测具有重要的价值。

Objective To study the relationship between plasma levels of tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)and interlukin-8(IL-8)in patients with lung infec-tion respiratory infection.Methods A total of 61 lung cancer patients admitted to Zhengzhou University Cancer Hospital from June 2022 to November 2022 were selected as the research subjects.They were divid-ed into an infection group(31 cases)and a control group(30 cases)based on the presence of lung infec-tion.Enzyme linked immunosorbent assay(ELISA)and radioimmunoassay were used to detect serum TNF-α,hs-CRP and IL-8 levels.The risk factors of pulmonary infection were screened through correlation anal-ysis and logistic regression analysis,and the predictive value was evaluated by the receiver operating char-acteristic(ROC)curve.Results The serum TNF-α,IL-8 and hs-CRP levels in the control group[(14.97±2.73),(25.83±5.68),(27.57±4.91)pg/ml]were significantly lower than those in the in-fectiongroup[(35.81±6.93),(52.26±8.78),(50.55±10.03)pg/ml,t=15.360,13.900,10.030,P<0.05].Sex,age,body mass index,pathological type,stage,complications,smoking room,drinking history and other indicators were not related to lung infection,while the levels of TNF-α,hs-CRP and IL-8 were positively correlated with pulmonary infection.Logistic regression analysis showed TNF-α[Wald χ^(2)=8.145,P<0.05,hazard ratio(HR)=1.214,95%confidence interval(CI):0.614-0.924],hs-CRP(Wald χ^(2)=5.254,P<0.05,HR=1.021,95% CI:0.254-0.812),IL-8(Wald χ^(2)=4.598,P<0.05,HR=0.947,95%Cl:0.987-1.211)were independent risk factors for lung infection in lung cancer patients.The ROC curve showed TNF-α,Hs-CRP and IL-8 had a higher predictive efficacy in predicting lung infection in lung cancer patients,and their combined predictive value was higher(AUC=0.918,95%CI:0.896-0.974).Conclusion Serum TNF-α,IL-8 and hs CRP levels in lung cancer patients after pulmonary infection are significantly increased,which are independent risk factors for lung infection and have important values in predicting lung infection.