肺癌合并肺部感染的相关危险因素分析

Risk factors associated with lung cancer complicated with lung infection

目的探讨肺癌患者合并肺部感染的相关危险因素。方法回顾性分析2020年8月至2022年9月西南医科大学附属医院收治的124例肺癌患者的临床资料,根据是否发生肺部感染分为感染组64例和未感染组60例。比较两组患者的临床资料以及白细胞数(WBC)、中性粒细胞数(NEU)、淋巴细胞数(LYM)、白介素4(IL-4)、白介素6(IL-6)、超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)、白蛋白(ALB)及血清淀粉样蛋白A(SAA)水平,应用多因素Logistic回归分析肺癌合并肺部感染的危险因素,并绘制受试者工作特征(ROC)曲线分析各指标对肺癌患者肺部感染的预测价值。结果两组患者的年龄、性别、高血压、糖尿病、是否吸烟、病理类型、TNM分期资料比较差异均无统计学意义(P>0.05)。感染组患者合并呼吸系统疾病的患病率为40.63%,明显高于未感染组的21.67%;IL-4、IL-6、WBC、NEU、PCT及hs-CRP、SAA水平分别为(3.09±1.73)ng/L、(118.63±375.46)ng/L、(8.39±3.19)×10^(9)/L、(6.21±2.89)×10^(9)/L、(0.40±1.40)ng/m L、(35.13±45.46)mg/L、(123.41±122.03)mg/L,明显高于未感染组的(2.33±1.28)ng/L、(19.47±44.28)ng/L、(6.73±1.91)×10^(9)/L、(4.82±1.63)×10^(9)/L、(0.07±0.11)ng/m L、(8.16±20.49)mg/L、(23.22±63.57)mg/L,差异均有统计学意义(P<0.05);而ALB水平为(38.58±6.72)g/L,明显低于未感染组的(41.04±4.47)g/L,差异均具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,IL-4>3.44 ng/L、WBC>8.575×10^(9)/L、SAA>17.96 mg/L均为肺癌合并肺部感染的独立危险因素(P<0.05);ROC曲线分析结果显示,IL-4、WBC、SAA单独预测肺癌合并肺部感染中ROC曲线下面积分别为0.629、0.649、0.803,三者联合预测肺癌合并肺部感染中ROC曲线下面积为0.821。结论肺癌患者IL-4、WBC、SAA水平升高,均为肺部感染发生的重要因素,联合检测三者水平有助于预测肺癌患者肺部感染的发生。

Objective To investigate the risk factors associated with lung infection in patients with lung can-cer.Methods A total of 124 lung cancer patients admitted to the Affiliated Hospital of Southwest Medical University from August 2020 to September 2022 were enrolled as the study subjects,and they were divided into an infection group(64 cases)and a non-infection group(60 cases).The clinical data,leukocyte count(WBC),neutrophil count(NEU),lym-phocyte count(LYM),interleukin4(IL-4),interleukin6(IL-6),high-sensitivity C-reactive protein(hs-CRP),procalcito-nin(PCT),albumin(ALB),and serum amyloid A(SAA)were compared between the two groups.Multivariate Logistic regression was applied to analyze the risk factors of lung cancer complicated with lung infection,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of each indicator for lung cancer patients with lung infection.Results There were no significant differences in age,gender,hypertension,diabetes,smoking status,patho-logical type,and TNM staging between the two groups(P>0.05).The prevalence of respiratory diseases in the infection group was 40.63%,which was significantly higher than 21.67%in the non-infection group;IL-4,IL-6,WBC,NEU,PCT,hs-CRP,and SAA levels were(3.09±1.73)ng/L,(118.63±375.46)ng/L,(8.39±3.19)×10^(9)/L,(6.21±2.89)×10^(9)/L,(0.40±1.40)ng/mL,(35.13±45.46)mg/L,and(123.41±122.03)mg/L,significantly higher(2.33±1.28)ng/L,(19.47±44.28)ng/L,(6.73±1.91)×10^(9)/L,(4.82±1.63)×10^(9)/L,(0.07±0.11)ng/mL,(8.16±20.49)mg/L,and(23.22±63.57)mg/L in the non-infection group;the differences were statistically significant(P<0.05).The ALB level was(38.58±6.72)g/L in the infection group,which was significantly lower than(41.04±4.47)g/L in the non-infection group(P<0.05).Multivari-ate logistic regression analysis showed that IL-4>3.44 ng/L,WBC>8.575×10^(9)/L,SAA>17.96 mg/L were independent risk factors for lung cancer combined with lung infection(P<0.05).ROC curve analysis showed that the area under ROC curve of IL-4,WBC,and SAA independently for predicting lung cancer complicated with lung infection was 0.629,0.649,and 0.803,respectively,and the area of the three indexes in combination for prediction was 0.821.Conclusion The levels of IL-4,WBC,and SAA increase in patients with lung cancer,and they are important factors for the occurrence of lung infection.The combined detection of the three indexes can help predict the occurrence of lung infection in patients with lung cancer.