血清CXCR3、CXCL10联合检测对食管癌患者术后肺部感染的诊断价值

The diagnostic value of combined detection of serum CXCR3 and CXCL10 postoperative pulmonary infection in patients with esophageal cancer

目的探讨血清CXC趋化因子受体3(CXCR3)和CXC趋化因子配体10(CXCL10)联合检测在食管癌患者术后肺部感染诊断中的价值。方法选取2020年2月至2023年2月于该院进行胸腔镜下食管癌切除术的181例食管癌患者作为研究对象,根据术后是否发生肺部感染分为感染组(63例)和未感染组(118例)。采用Pearson相关分析血清CXCR3与CXCL10表达水平的相关性。采用多因素Logistic回归分析食管癌患者术后发生肺部感染的影响因素。采用受试者工作特征(ROC)曲线分析血清CXCR3和CXCL10对食管癌患者术后肺部感染的诊断价值。结果感染组血清CXCR3和CXCL10表达水平均高于未感染组(P<0.05);食管癌患者血清CXCR3与CXCL10表达水平呈正相关(r=0.796,P<0.05)。感染组有吸烟史、发生肺转移、肿瘤位于胸部的患者比例高于未感染组(P<0.05)。吸烟史、肺转移、肿瘤位置、CXCR3、CXCL10为食管癌患者术后发生肺部感染的影响因素(P<0.05)。血清CXCR3、CXCL10联合检测诊断食管癌患者术后肺部感染的特异度为96.61%。血清CXCR3、CXCL10单独诊断食管癌患者术后肺部感染的曲线下面积(AUC)分别为0.811、0.793,二者联合检测的AUC为0.878,联合检测的AUC大于血清CXCR3和CXCL10单独检测(Z二者联合-CXCR3=1.984,P=0.047;Z二者联合-CXCL10=2.190,P=0.029)。结论血清CXCR3和CXCL10表达水平与食管癌患者术后肺部感染的发生密切相关,二者联合检测能够用于临床辅助诊断食管癌患者术后肺部感染。

Objective To investigate the value of combined detection of serum CXC chemokine receptor 3(CXCR3)and CXC chemokine ligand 10(CXCL10)in the diagnosis of postoperative lung infections in esophageal cancer patients.Methods A total of 181 patients who underwent thoracoscopic esophagectomy for esophageal cancer at the hospital from February 2020 to February 2023 were selected as the study subjects.The patients were divided into the infection group(63 cases)and the non-infection group(118 cases)based on the presence of postoperative pulmonary infection.Pearson correlation analysis was used to assess the correlation between serum CXCR3 and CXCL10 expression levels.Multivariate Logistic regression was applied to analyze the risk factors for postoperative pulmonary infection in esophageal cancer patients.Receiver operating characteristic(ROC)curve was used to assess the diagnostic value of serum CXCR3 and CXCL10 for detecting postoperative pulmonary infection in patients with esophageal cancer.Results The expression levels of serum CXCR3 and CXCL10 in the infection group were significantly higher than those in the non-infection group(P<0.05),and there was a positive correlation between the serum levels of CXCR3 and CXCL10 in esophageal cancer patients(r=0.796,P<0.05).The proportions of patients with a history of smoking,pulmonary metastasis and tumors located in the chest were higher in the infection group than those in the non-infection group(P<0.05).A history of smoking,pulmonary metastasis,tumor location,CXCR3 and CXCL10 were identified as influencing factors for postoperative pulmonary infection in esophageal cancer patients(P<0.05).The combined detection of serum CXCR3 and CXCL10 had a specificity of 96.61%for diagnosing postoperative pulmonary infection in esophageal cancer patients.The area under the curve(AUC)for the individual diagnosis of serum CXCR3 and CXCL10 were 0.811 and 0.793 respectively,while the AUC for the combined detection was 0.878,which was significantly bigger than that for the individual test(Z combined-CXCR3=1.984,P=0.047;Z combined-CXCL10=2.190,P=0.029).Conclusion The expression levels of serum CXCR3 and CXCL10 are closely related to the occurrence of postoperative pulmonary infection in esophageal cancer patients.The combined detection of these markers can be used for clinical auxiliary diagnosis of postoperative pulmonary infection in this population.