血清Presepsin、PGRN对肺癌患者术后并发肺部感染的预测价值

The predictive value of serum Presepsin and PGRN for postoperative pulmonary infection in patients with lung cancer

目的探讨血清可溶性白细胞分化抗原14亚型(Presepsin)、颗粒蛋白前体(PGRN)对肺癌患者术后并发肺部感染的预测价值。方法选取2019年8月至2022年2月在该院进行胸腔镜肺癌根治术治疗的非小细胞肺癌(NSCLC)患者184例为研究对象,根据患者术后住院期间是否发生肺部感染分为感染组(64例)和未感染组(120例)。采用酶联免疫吸附试验检测术后6 h患者血清Presepsin、PGRN及相关感染标志物水平;采用Pearson相关分析感染组患者血清Presepsin、PGRN与感染标志物水平的相关性;采用多因素Logistic回归分析NSCLC患者术后并发肺部感染的影响因素;采用受试者工作特征(ROC)曲线评价血清Presepsin、PGRN对NSCLC患者术后并发肺部感染的预测价值。结果感染组血清Presepsin、PGRN、降钙素原(PCT)、C反应蛋白(CRP)、白细胞计数(WBC)水平均高于未感染组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,感染组血清Presepsin水平与PGRN呈正相关(P<0.05),Presepsin、PGRN水平与PCT、CRP、WBC均呈正相关(P<0.05)。多因素Logistic回归分析结果显示,Presepsin、PGRN是NSCLC患者术后并发肺部感染的独立影响因素(P<0.05)。血清Presepsin、PGRN联合预测NSCLC患者术后并发肺部感染的ROC曲线下面积(AUC)大于Presepsin单独预测的AUC(Z=2.450,P=0.014)及PGRN单独预测的AUC(Z=2.526,P=0.012)。结论NSCLC术后并发肺部感染患者血清Presepsin、PGRN水平升高,二者联合检测对肺癌患者术后并发肺部感染有一定的预测价值。

Objective To investigate the predictive value of serum soluble leukocyte differentiation antigen 14 subtype(Presepsin)and granule protein precursor(PGRN)for postoperative pulmonary infection in patients with lung cancer.Methods A total of 184 patients with non-small cell lung cancer(NSCLC)who underwent thoracoscopic radical resection in the hospital from August 2019 to February 2022 were selected as the research objects.According to whether pulmonary infection occurred during postoperative hospitalization,the patients were divided into infection group(64 cases)and non-infection group(120 cases).The serum levels of Presepsin,PGRN and related infection markers were detected by enzyme-linked immunosorbent assay at 6 h after operation.Pearson correlation analysis was used to analyze the correlation between serum Presepsin,PGRN and infection markers in the infection group.Multivariate Logistic regression was used to analyze the influencing factors of postoperative pulmonary infection in patients with NSCLC.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum Presepsin and PGRN for postoperative pulmonary infection in patients with NSCLC.Results The levels of serum Presepsin,PGRN,procalcitonin(PCT),C-reactive protein(CRP)and white blood cell count(WBC)in the infection group were higher than those in the non-infection group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the serum Presepsin level was positively correlated with PGRN in the infection group(P<0.05),and the serum Presepsin and PGRN levels were positively correlated with PCT,CRP and WBC(P<0.05).Multivariate Logistic regression analysis showed that Presepsin and PGRN were independent influencing factors for postoperative pulmonary infection in patients with NSCLC(P<0.05).The area under the ROC curve(AUC)of serum Presepsin combined with PGRN in predicting postoperative pulmonary infection in NSCLC patients was greater than that of Presepsin alone(Z=2.450,P=0.014)and PGRN alone(Z=2.526,P=0.012).Conclusion The levels of serum Presepsin and PGRN are increased in NSCLC patients with postoperative pulmonary infection.The combined detection of Presepsin and PGRN has certain predictive value for lung cancer patients with postoperative pulmonary infection.