肺癌新辅助化疗患者血清C-反应蛋白、降钙素原和细胞角蛋白19片段抗原表达与肺部感染严重程度评分关系

Correlation between expression levels of serum CRP,PCT,CYFRA21-1 and severity score of pulmonary infection in patients with lung cancer undergoing neoadjuvant chemotherapy

目的:研究肺癌新辅助化疗(NACT)患者血清C-反应蛋白(CRP)、降钙素原(PCT)和细胞角蛋白19片段抗原(CYFRA21-1)表达水平与肺部感染严重程度评分(PSI)的关系。方法:回顾性收集76例行NACT治疗的肺癌患者作为研究对象,收集所有患者的临床资料,应用PSI评分评价并发肺部感染患者的严重程度,检测各患者血清CRP、PCT和CYFRA21-1的表达水平。结果:76例患者行NACT后,共30例(39.47%)发生肺部感染,46例未发生肺部感染(60.53%);30例肺部感染患者中,依据PSI评分,可分为轻度7例(23.33%)、中度14例(46.67%)、重度9例(30.00%)。感染组和非感染组患者在性别、体重指数(BMI)、病程和病理分型方面相比无统计学差异(均P>0.05);而在年龄、是否有吸烟史、是否合并高血压和糖尿病以及TNM分期方面比较有统计学差异(均P<0.05)。感染组患者血清CRP、PCT和CYFRA21-1的表达水平均显著高于非感染组患者(均P<0.05)。轻度、中度和重度感染患者之间血清CRP、PCT和CYFRA21-1的表达水平相比有统计学差异(均P<0.05)。Pearson相关性分析显示,患者血清CRP、PCT和CYFRA21-1的表达水平与PSI得分呈正相关(均P<0.05)。多元线性回归分析显示,血清CRP(OR=1.852,95%CI:1.669~2.054)、PCT(OR=1.255,95%CI:1.118~1.409)和CYFRA21-1(OR=2.421,95%CI:1.311~4.470)的表达水平均为肺癌患者行NACT后发生肺部感染的独立危险因素。结论:肺癌NACT患者血清CRP、PCT和CYFRA21-1表达与术后并发肺部感染的严重程度密切相关,可作为早期诊断和评估感染严重程度的重要生物学指标。

Objective:To investigate the correlation between expression levels of serum C-reactive protein(CRP),procalcitonin(PCT),cytokeratin 19 fragment antigen 21-1(CYFRA21-1) and severity score of pulmonary infection in patients with lung cancer undergoing neoadjuvant chemotherapy(NACT).Methods:A total of 76 patients with lung cancer underwent NACT were accepted as research subjects.The clinical data of all patients were collected.The severity of pulmonary infection was evaluated by PSI score,and the expression levels of CRP,PCT and CYFRA21-1 in serum were detected.Results:After 76 patients underwent NACT,30 patients(39.47%) had pulmonary infection,and 46 patients had no pulmonary infection(60.53%).Among the 30 patients with pulmonary infection,according to PSI score,they were divided into mild(7 cases,23.33%),moderate(14 cases,46.67%) and severe(9 cases,30.00%).The sexuality,BMI,course of disease and pathological type of infected group and non-infected group had no significant difference(all P>0.05),while age,whether coexist smoking history,hypertension,diabetes and TNM stage were significantly different(all P<0.05).The expression levels of serum CRP,PCT and CYFRA21-1 of infected group were higher than those of non-infected group(all P<0.05).The expression levels of serum CRP,PCT and CYFRA21-1 between mild,moderate and severe group had significant difference(all P<0.05).Pearson correlation analysis showed that the expression levels of serum CRP,PCT and CYFRA21-1 were positively correlated with PSI score(P<0.05).Multiple linear regression analysis showed that the expression levels of serum CRP(OR=1.852,95%CI:1.669 to 2.054),PCT(OR=1.255,95%CI:1.118 to 1.409) and CYFRA21-1(OR=2.421,95%CI:1.311 to 4.470) were independently associated with pulmonary infection in patients with lung cancer undergoing NACT.Conclusion:The expression levels of serum CRP,PCT and CYFRA21-1 were closely related with severity of pulmonary infection in patients with lung cancer undergoing NACT,which can be important biological indicators for early diagnosis and evaluation of severity of pulmonary infection.