血清降钙素原与C-反应蛋白水平对放射性肺炎的预测

Prediction of radiation pneumonia by serum procalcitonin and C-reactive protein levels

目的分析放射治疗后发生放射性肺炎肺癌患者的血清降钙素原(PCT)和C-反应蛋白(CRP)水平,探讨其作为放射性肺炎早期预测指标的可能性。方法选取2017年1月—2019年2月厦门大学附属第一医院收治的45例放射性肺炎的肺癌患者作为观察组,另选取46例未发生放射性肺炎的肺癌患者作为对照组。检测并比较两组患者血清PCT、CRT水平及阳性率,通过受试者工作特征(ROC)曲线分析PCT、CRP诊断放射性肺炎的最佳阈值、敏感度、特异度。结果观察组PCT、CRT水平均高于对照组,差异有统计学意义[(2.32±0.25)ng/ml vs.(0.86±0.12)ng/ml,(9.11±1.03)ng/ml vs.(5.76±2.47)ng/ml,P<0.05]。观察组PCT及CRP阳性率均高于对照组,差异有统计学意义(75.56%vs.34.78%,66.67%vs.43.48%,P<0.05)。PCT相应的敏感度为84%,特异度为85%,而CRP分别为40%和60%。结论血清PCT和CRT对放射性肺炎可能有预测价值,PCT诊断价值更为突出。

Objective To investigate the serum levels of procalcitonin(PCT)and C-reactive protein(CRP)in patients with radiation pneumonia,and to evaluate their possibilities as early predictor of radiation pneumoniathe.Methods Totally 45 cases of lung cancer patients who developed radiation pneumonin after routine radiotherapy during Janury 2017 to Feburay 2019 were enrolled as the observation group,and 46 patients who did not develop radiation pneumonin during the same period were considered as the control group.Levels and positive rates of PCT and CRP were measured and compared between the two group.The best threshold,sensitivity and specificity of PCT and CRP in the diagnosis of radiation pneumonitis were analyzed by ROC curve.Results Serum PCT levels of patients with and without radiation pneumonia were(2.32±0.25)ng/ml and(0.86±0.12)ng/ml,and serum CRP levels of patients with and without radiation pneumonia were(9.11±1.03)ng/ml and(5.76±2.47)ng/ml,and there were differences between the two groups(P<0.05).The positive rates of PCT and CRP in the observation group were higher than those in the control group,and the difference was statistically significant(75.56%vs.34.78%,66.67%vs.43.48%,P<0.05).The corresponding sensitivity of PCT was 84%and specificity was 85%,while CRP was 40%and 60%respectively.Conclusions Serum PCT and CRT may have predictive value for radiation pneumonitis,and the diagnostic value of PCT is more prominent.