淀粉样蛋白A和超敏C-反应蛋白与血清降钙素原对原发性肺癌患者肺部感染的诊断效果

Effects of amyloid protein, high-sensitivity C-reactive protein and serum procalcitonin on diagnosis of pulmonary infection in patients with primary lung cancer

目的探讨血清淀粉样蛋白A(Serum Amyloid A Protein SAA)、超敏C-反应蛋白(hs-CRP)和血清降钙素原(PCT)对原发性肺癌患者肺部感染病原菌的诊断效果。方法选取2015年7月-2018年7月于广东省第二人民医院接受治疗的314例原发性肺癌患者为研究对象,按照患者住院过程中是否发生感染分为细菌感染组、病毒感染组、真菌感染组、非感染组。检测各组患者血清SAA、hs-CRP、PCT指标水平。并采用受试者工作曲线(ROC)对细菌感染患者、病毒感染患者血清SAA、hs-CRP、PCT指标诊断价值进行评价。结果原发性肺癌患者细菌感染组血清SAA、hs-CRP、PCT指标水平明显高于病毒感染组、真菌感染组和非感染组(P<0.05),非感染组血清SAA、hs-CRP、PCT指标水平最低。SAA诊断原发性肺癌患者细菌感染的敏感度、特异度、阳性似然值分别为0.837、0.973、0.168,诊断病毒感染的敏感度、特异度、阳性似然值分别为0.532、0.940、0.494,均优于hs-CRP和PCT。结论原发性肺癌患者发生肺部感染后血清SAA、hs-CRP、PCT指标水平变化明显,血清SAA、hs-CRP、PCT诊断细菌感染患者较病毒感染患者准确性高,临床医师可以根据血清SAA、hs-CRP、PCT检测结果对患者肺部感染情况进行初步判断。

OBJECTIVE To explore the effects of serum amyloid A(SAA) protein, high-sensitivity C-reactive protein(hs-CRP) and serum procalcitonin(PCT) on diagnosis of pulmonary infection in the patients with primary lung cancer. METHODS Totally 314 patients with primary lung cancer who were treated in the Second People′s Hospital of Guangdong province from Jul 2015 to Jul 2018 were recruited as the study objects and divided into the bacterial infection group, the viral infection group, the fungal infection group and the non-infection group according to the infection that occurred during the hospital stay.The levels of serum SAA, hs-CRP and PCT of the four groups of patients were detected, and the values of serum SAA, hs-CRP and PCT in diagnosis of bacterial infection and viral infection were evaluated by means of receiver-operating-characteristic(ROC) curve. RESULTS Among the patients with primary lung cancer, the levels of serum SAA, hs-CRP and PCT of the bacterial infection group were significantly higher than those of the viral infection group, the fungal infection group and the non-infection group(P<0.05), and the levels of serum SAA, hs-CRP and PCT of the non-infection group were the lowest.The sensitivity, specificity and positive likelihood of SAA were respectively 0.837, 0.973 and 0.168 in diagnosis of bacterial infection in the primary lung cancer patients and were respectively 0.532, 0.940 and 0.494 in diagnosis of viral infection, it was superior to hs-CRP and PCT. CONCLUSION The levels of serum SAA, hs-CRP and PCT of the primary lung cancer patients with pulmonary infection change significantly, the accuracy of the serum SAA, hs-CRP and PCT is higher in diagnosis of bacterial infection than viral infection, and it is necessary for clinicians to make a preliminary diagnosis based on the levels of serum SAA, hs-CRP and PCT.