Th17/Treg联合PCT值对乳腺癌患者术后化疗医院感染的预测价值分析

Predictive value analysis of Th17/Treg combined with PCT fornosocomial infection of breast cancer patients undergoing postoperative chemotherapy

目的探究辅助性T细胞17(Th17)/调节性T细胞(Treg)联合血清降钙素原(PCT)在乳腺癌患者术后化疗医院感染预测中的价值。方法选取2017年6月至2019年6月在本院行乳腺癌根治术治疗,并在术后接受化疗的乳腺癌患者152例,收集患者的一般临床资料和血清学检测资料。根据术后化疗后是否发生医院感染将患者分为感染组(n=31)和非感染组(n=121),比较两组患者的Th17/Treg和血清PCT水平变化,采用受试者工作特征曲线(ROC)分析Th17/Treg和血清PCT对乳腺癌患者术后化疗医院感染的预测价值。结果感染组患者的Th17、Th17/Treg和PCT水平高于非感染组,Treg水平低于非感染组,差异均具有统计学意义(P<0.05);ROC曲线分析结果显示,Th17/Treg、PCT和Th17/Treg联合PCT的AUC值分别为0.838、0.780和0.863,对乳腺癌患者术后化疗发生医院感染的预测均具有统计学意义(P<0.05),且Th17/Treg联合PCT预测价值高于单一指标。结论乳腺癌患者术后化疗发生医院感染的患者,其Th17/Treg和PCT水平高于非感染患者,Th17/Treg联合PCT对判断乳腺癌患者术后化疗发生医院感染具有较高的预测价值。

Objective To explore the predictive value of helper T cells 17(Th17)/regulatory T cells(Treg)combined with serum procalcitonin(PCT)in nosocomial infection of patients with breast cancer undergoing postoperative chemotherapy.Methods A total of 152 breast cancer patients who underwent radical mastectomy and postoperative chemotherapy in the hospital from June 2017 to June 2019 were enrolled.The clinical data and serological examination data were collected.According to presence or absence of nosocomial infection after postoperative chemotherapy,patientswere divided into the infection group(n=31)and non⁃infection group(n=121).The changes in Th17/Treg and serum PCT levels were compared between the two groups.The predictive value of Th17/Treg and serum PCT for nosocomial infection was analyzed usingthe receiver operating characteristics(ROC)curves.Results The numberof Th17,Th17/Treg ratio,and PCT value in the infection group were higher than those in the non⁃infection group,while Treg cellswerelessthan thosein the non⁃infection group(P<0.05).The results of ROC curve analysis showed that the AUC values of Th17/Treg,PCT,and Th17/Treg combined with PCT for predicting nosocomial infection were 0.838,0.780 and 0.863,respectively(P<0.05).The predictive value of Th17/Treg combined with PCT is the best.Conclusion After postoperative chemotherapy,the ratioof Th17/Treg and PCT level in breast cancer patients with nosocomial infection are higher than those without nosocomial infection.The ratio of Th17/Treg combined with PCT has a higher predictive value for nosocomial infection in breast cancer patients undergoing postoperative chemotherapy.