血清PCT、SAA及ACE2对非小细胞肺癌患者化疗期间肺部感染的鉴别诊断价值分析

摘要/Abstract

摘要： 目的探讨分析血清降钙素原（PCT）、血清淀粉样蛋白A（SAA）及血管紧张素转换酶2（ACE2）对非小细胞肺癌（NSCLC）患者化疗期间肺部感染的鉴别诊断价值。方法回顾性分析2020年1月—2022年12月在武威市人民医院接受化疗并于化疗期间发生肺部感染的80例NSCLC患者及同期50例NSCLC化疗未感染患者的临床资料,将其分别纳入感染组和未感染组。比较各组血清PCT、SAA及ACE2水平,并采用受试者工作特征（ROC）曲线分析血清PCT、SAA及ACE2单独及联合检测对NSCLC化疗患者肺部细菌感染、病毒感染的鉴别诊断价值。结果感染组血清PCT、SAA和ACE2水平均高于非感染组,差异有统计学意义（P<0.05）;细菌感染患者血清PCT、SAA和ACE2水平均高于其他两种类型感染,病毒感染患者血清PCT水平低于真菌感染患者,SAA水平高于真菌感染患者,细菌感染患者血清ACE2高于病毒感染组,差异有统计学意义（P<0.05）,病毒感染和真菌感染患者血清ACE2水平比较,差异无统计学意义（P>0.05）;PCT和SAA水平单独鉴别诊断细菌感染的AUC较高,分别为0.964（95%CI：0.926~1.000）和0.920（95%CI：0.856~0.984）,诊断临界值（cut-off）值分别为≥47.4 ng/mL和≥44.9 μg/mL;PCT联合SAA鉴别诊断细菌感染的效能最佳,其敏感度和特异度分别为94.74%、95.24%;PCT和SAA水平单独鉴别诊断细菌感染的AUC较高,分别为1.000（95%CI：1.000~1.000）和0.965（95%CI：0.914~0.984）,诊断cut-off值分别为≤8.4 ng/mL和≥16.1 μg/mL。结论血清PCT和SAA水平对于非小细胞肺癌患者化疗期间发生肺部感染具有良好的鉴别诊断价值,两指标联合应用效果更佳。

关键词: 降钙素原, 血清淀粉样蛋白A, 血管紧张素转换酶2, 肺部感染, 非小细胞肺癌, 化疗, 鉴别诊断

Abstract: Objective To explore the differential diagnostic value of serum PCT, SAA, and ACE2 levels in lung infection during chemotherapy in non-small cell lung cancer (NSCLC) patients. Methods A retrospective analysis was conducted on the clinical data of 80 NSCLC patients who underwent chemotherapy in Wuwei People's Hospital from January 2020 to December 2022 and developed lung infections during the chemotherapy period, as well as 50 NSCLC patients who were not infected during chemotherapy during the same period. They were included in the infected and uninfected groups, respectively. Compare the levels of serum PCT, SAA, and ACE2 in each group, and analyze the differential diagnostic value of individual and combined detection of serum PCT, SAA, and ACE2 in lung bacterial and viral infections in NSCLC chemotherapy patients using receiver operating characteristic (ROC) curves. Results The levels of serum PCT, SAA and ACE2 in infected group were significantly higher than those in non-infected group (P<0.05). The serum PCT, SAA and ACE2 levels of bacterial infection patients were significantly higher than those of the other two types of infection, the serum PCT level of viral infection patients was significantly lower than that of fungal infection patients, the serum SAA level was significantly higher than that of fungal infection patients, and the serum ACE2 level of bacterial infection patients was significantly higher than that of viral infection group (P<0.05). There was no significant difference in serum ACE2 level between viral infection and fungal infection (P>0.05). The AUCs of PCT and SAA were 0.964 (95%CI: 0.926~1.000) and 0.920 (95%CI: 0.856~0.984), respectively, and the cutoff values were ≥47.4 ng/mL and ≥44.9 μg/mL, respectively. The sensitivity and specificity of PCT combined with SAA were 94.74% and 95.24%, respectively. The AUCs of PCT and SAA were 1.000 (95%CI: 1.000~1.000) and 0.965 (95%CI: 0.914~0.984), respectively, and the cutoff values were ≤8.4 ng/mL and ≥16.1 μg/mL, respectively. Conclusion Serum PCT and SAA levels have good differential diagnostic value for lung infection in non-small cell lung cancer patients during chemotherapy, and the combination of the two indicators is more effective.

Key words: PCT, SAA, ACE2, pulmonary infection, non-small cell lung cancer, chemotherapy, differential diagnosis

中图分类号:

R446.1

于天良, 沈丽梅. 血清PCT、SAA及ACE2对非小细胞肺癌患者化疗期间肺部感染的鉴别诊断价值分析[J]. 中华养生保健, 2024, 42(23): 192-196.

YU Tian-liang, SHEN Li-mei. Analysis of the Differential Diagnostic Value of Serum PCT, SAA, and ACE2 in Lung Infection During Chemotherapy in Non-small Cell Lung Cancer Patients[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(23): 192-196.

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