降钙素原和Th1/Th2比值对结直肠癌患者术后感染性并发症的诊断价值

Value of procalcitonin and Th1/Th2 ratio in diagnosis of postoperative infectious complications in colorectal cancer patients

目的探讨降钙素原(PCT)和辅助性T细胞(Th)Th1/Th2比值对结直肠癌患者术后发生感染性并发症的诊断价值。方法选取2015年1月-2017年12月医院收治的95例结直肠癌术后合并感染性并发症患者为感染组,95例术后未发生感染性并发症的结直肠癌患者为对照组。收集两组患者术前1 d、术后3 d、7 d晨起空腹外周血,采用全自动血液细胞分析仪检测白细胞(WBC)计数,采用酶联免疫吸附测定(ELISA)试验检测血清PCT水平,采用流式细胞术检测外周血Th1、Th2细胞含量及Th1/Th2比值,应用受试者工作特征(ROC)曲线分析WBC、PCT和Th1/Th2比值对结直肠癌患者术后发生感染性并发症的诊断价值。结果术后3 d、7 d,感染组患者血清PCT水平、外周血Th2细胞含量、WBC计数均高于对照组,Th1/Th2比值低于对照组(P<0.05);ROC曲线显示,术后3 d、7 d,PCT、Th1/Th2比值诊断结直肠癌患者术后发生感染性并发症的AUC均>0.80。PCT联合Th1/Th2比值诊断结直肠癌患者术后发生感染性并发症的敏感性和特异性与指标单独诊断相近。结论 PCT和Th1/Th2比值是早期诊断结直肠癌患者术后发生感染性并发症的快速、可靠指标。

OBJECTIVE To explore the value of procalcitonin(PCT)and T helper cell(Th)Th1/Th2 ratio in diagnosis of postoperative infectious complications in the colorectal cancer patients.METHODS From Jan 2015 to Dec 2017,totally 95 colorectal cancer patients who were complicated with postoperative infectious complications were chosen as the infection group,and 95 colorectal cancer patients who were not complicated with infectious complications were set as the control group.The fasting peripheral blood samples were collected from the two groups of patients 1 day before the surgery and after the surgery for 3 and 7 days,white blood cell(WBC)counts were determined by using automatic blood cell analyzer,the serum PCT level was determined by means of enzyme-linked immunosorbent assay(ELISA),the levels of peripheral blood Th1 and Th2 as well as Th1/Th2 ration were detected with the use of flow cytometry,and the value of WBC,PCT and Th1/Th2 ratio in diagnosis of postoperative infectious complications in the colorectal cancer patients was analyzed through receiver operating characteristic(ROC)curve.RESULTS The levels of serum PCT,peripheral blood Th2 level and WBC level of the infection group were significantly higher than those of the control group after the surgery for 3 and 7 days,and the Th1/Th2 ratio of the infection group was significantly lower than that of the control group(P<0.05).ROC curve analysis showed that the AUC of both the PCT and Th1/Th2 ratio were greater than 0.80 in the diagnosis of postoperative infectious complications in the colorectal cancer patients.The sensitivity and specificity of the PCT combined with Th1/Th2 ratio were similar to those of the single index in diagnosis of postoperative infectious complications in the colorectal cancer patients.CONCLUSION The PCT and Th1/Th2 ratio may facilitate the early diagnosis of postoperative infectious complications in the colorectal cancer patients and are reliable.