中性粒细胞CD64、CD11b联合全身免疫炎症指数预测结直肠癌术后腹腔感染的价值

The value of neutrophil CD64 and CD11b combined with systemic immune inflammatory index in predicting abdominal infection after colorectal cancer surgery

目的探究中性粒细胞CD64、CD11b联合全身免疫炎症指数(SII)预测结直肠癌术后腹腔感染的价值。方法回顾性选取2019年6月至2021年5月于秦皇岛市第一医院接受结直肠癌术治疗的96例患者为研究对象,收集所有受试者临床资料,根据是否发生术后腹腔感染分为感染组(n=52)和未感染组(n=44)。采用Logistic回归分析结直肠癌术后发生腹腔感染的影响因素,比较两组患者术前中性粒细胞CD64、CD11b水平和SII,并采用受试者工作特征(ROC)曲线分析中性粒细胞CD64、CD11b和SII对于结直肠癌术后腹腔感染的预测价值。结果感染组患者年龄≥60岁占比为63.46%,高于未感染组(38.64%),体重指数<23 kg/m2占比为40.38%,高于未感染组(20.45%),开胸手术占比25.00%,高于未感染组(9.09%),差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄、体重指数和手术方式与结直肠癌术后发生腹腔感染之间具有相关性。感染组术前SII和术后24 h时中性粒细胞CD64、CD11b均高于未感染组,差异均有统计学意义(P<0.05)。ROC曲线分析可知,术前SII和术后中性粒细胞CD64、CD11b预测结直肠癌术后发生腹腔感染的AUC分别为0.717、0.787和0.751,其中CD64敏感度最高,SII特异度最高,三者联合诊断的整体效能最高。结论年龄、体重指数和手术方式是结直肠癌术后发生腹腔感染的影响因素,SII、CD64和CD11b对于是否发生术后腹腔感染有重要价值,其中CD64的敏感度最高,SII特异度最高,三者联合诊断的整体效能最高。

Objective To explore the value of neutrophil CD64,CD11b combined with systemic immune inflammation index(SII)in predicting abdominal infection after colorectal cancer surgery.Methods Ninety-six patients patients who received colorectal cancer surgery in The First Hospital of Qinhuangdao from June 2019 to May 2021 were retrospectively selected as the study subjects.Clinical data of all subjects were collected.They were divided into infected group(n=52)and uninfected group(n=44)according to whether there was postoperative abdominal infection.Logistic regression was used to analyze the influencing factors of postoperative abdominal infection of colorectal cancer,and the levels of neutrophil CD64,CD11b and SII of the two groups were compared before surgery,The predictive value of neutrophil CD64,CD11b and SII for abdominal infection after colorectal cancer surgery was analyzed by subject work(ROC)curve.Results The proportion of patients aged≥60 years in the infected group was 63.46%,which was higher than that in the uninfected group(38.64%),the proportion of patients with body mass index<23 kg/m~2 was 40.38%,which was higher than that in the uninfected group(20.45%),and the proportion of patients undergoing thoracotomy was 25.00%,which was higher than that in the uninfected group(9.09%),the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that there was a correlation between age,body mass index and surgical methods and the occurrence of abdominal infection after colorectal cancer surgery.The levels of neutrophil CD64 and CD11b in the infected group were higher than those in the uninfected group before operation,the differences were statistically significant(P<0.05).According to the ROC curve analysis,the AUC of preoperative SII and postoperative neutrophil CD64 and CD11b predicting postoperative abdominal infection of colorectal cancer were 0.717,0.787 and 0.751,respectively,of which the sensitivity of CD64 was the highest,the specificity of SII was the highest,and the overall efficiency of combined diagnosis of the three was the highest.Conclusion Age,BMI and operation mode are the influencing factors for the occurrence of abdominal infection after colorectal cancer surgery.SII,CD64 and CD11b are of great value for the occurrence of postoperative abdominal infection.Among them,CD64 has the highest sensitivity,SII has the highest specificity,and the combined diagnosis of the three has the highest overall efficiency.