血清C反应蛋白、降钙素原及髓样细胞触发受体-1对非小细胞肺癌术后肺部细菌感染的诊断价值

Clinical Diagnostic Value of Serum CRP,PCT and sTREM-1 Detection in Lung Bacterial Infection in Patients with Non-small Cell Lung Cancer

目的探讨血清C反应蛋白(CRP)、降钙素原(PCT)及髓样细胞触发受体-1(sTREM-1)联合检查对非小细胞肺癌(NSCLC)患者术后并发肺部细菌感染的诊断价值。方法选取实施肺癌根治性手术的NSCLC患者212例进行前瞻性研究,根据术后是否发生肺部感染分为感染组44例、非感染组168例,对比两组患者术后第1 d、术后第3 d、术后第5 d、术后第7 d的血清CRP、PCT、sTREM-1水平,绘制ROC曲线分析三项指标单用或联合应用诊断肺部细菌感染的价值。结果感染组患者的血清CRP、PCT、sTREM-1水平在术后第1 d与非感染组比较差异无统计学意义(P>0.05);感染组患者的血清CRP、PCT、sTREM-1水平在术后第3~7 d均显著高于非感染组(P<0.05);以术后第5d的结果绘制ROC曲线,血清CRP鉴别诊断肺部发生细菌感染的灵敏度84.29%、特异度74.03%、AUC值为0.790;血清PCT鉴别诊断肺部发生细菌感染灵敏度88.17%、特异度78.30%、AUC值为0.835;血清sTREM-1鉴别诊断肺部发生细菌感染灵敏度67.48%、特异度77.04%、AUC值为0.738;三项指标联合应用鉴别诊断肺部发生细菌感染灵敏度95.28%、特异度87.31%、AUC值为0.911。结论血清CRP、PCT、sTREM-1联合检测对于NSCLC患者根治术后发生肺部细菌感染具有较高的临床诊断价值。

Objective To investigate the combined detection of serum C-reactive protein(CRP),procalcitonin(PCT) and myeloid cell-triggered receptor-1(sTREM-1) in the diagnosis of postoperative pulmonary bacterial infection in patients with non-small cell lung cancer(NSCLC).Methods A total of 208 patients with NSCLC who underwent radical lung cancer surgery were enrolled.According to whether there were pulmonary infections in the hospital, 44 patients were infected and 168 patients were in non-infected group.The first 2 days after surgery, the third day after surgery.Serum CRP,PCT,sTREM-1 levels at 5 days after surgery and 7 days after surgery, and the value of three indicators of ROC curve analysis alone or in combination for the diagnosis of pulmonary bacterial infection were drawn.Results There were no significant differences in serum CRP,PCT and sTREM-1 levels between the infected group and the non-infected group(P>0.05).The serum CRP,PCT and sTREM-1 levels in the infected group were postoperatively.3~7 d were significantly higher than the non-infected group(P<0.05).The ROC curve was drawn on the 5 th day after operation.The sensitivity of serum CRP in differential diagnosis of pulmonary bacterial infection was 84.29%,specificity was 74.03%,and AUC was 0.790.Serum PCT differential diagnosis of pulmonary bacterial infection sensitivity 88.17%,specificity 78.30%,AUC value 0.835;serum sTREM-1 differential diagnosis of bacterial infection in the lungs 67.48%,specificity 77.04%,AUC value 0.738;The combined indicators were used to differentially diagnose the bacterial infection in the lungs with a sensitivity of 95.28%,specificity of 87.31%,and AUC of 0.911.Conclusion The combined detection of serum CRP,PCT and sTREM-1 has a high clinical diagnostic value for pulmonary bacterial infection after radical surgery in patients with NSCLC.