| 陈家群.肺部感染对结直肠癌手术患者血清内毒素、PGRN、IL-35水平及预后的影响[J].浙江中西医结合杂志,2025,35(9): |
| 肺部感染对结直肠癌手术患者血清内毒素、PGRN、IL-35水平及预后的影响 |
| Effects of Pulmonary Infection on Serum Endotoxin, PGRN, IL-35 Levels and Prognosis in Patients Undergoing Colorectal Cancer Surgery |
| 投稿时间：2024-08-06 修订日期：2025-06-23 |
| DOI： |
| 中文关键词: 结直肠癌手术 肺部感染 内毒素 颗粒蛋白前体 白细胞介素-35 预后 评估价值 |
| 英文关键词:colorectal cancer surgery pulmonary infection endotoxin granulin precursor interleukin-35 prognosis evaluation value |
| 基金项目:浙江省医药卫生科技计划（2020ky1002） |
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| 中文摘要: |
| 目的 分析肺部感染对结直肠癌手术患者血清内毒素(ET)、颗粒蛋白前体(PGRN)、白细胞介素-35(IL-35)水平及预后的影响。方法 以2021年2月~2022年2月本院接受结直肠癌手术后肺部感染患者150例为研究组,另选取同期于本院接受结直肠癌手术术后未合并肺部感染患者145例为对照组,研究组中根据肺部感染的严重程度又分为轻度感染组(n=65)及中重度感染组(n=85)。测定并比较感染组与未感染组血清ET、PGRN、IL-35水平,比较不同程度肺部感染患者血清ET、PGRN、IL-35水平。术后随访2年,观察所有研究对象的预后情况。以受试者特征工作曲线(ROC)分析血清ET、PGRN、IL-35联合检测对结直肠癌手术患者术后合并肺部感染的评估价值。结果 感染组的血清ET、PGRN水平高于未感染组,IL-35水平低于未感染组(P<0.05)；中重度感染组的血清ET、PGRN水平高于轻度感染组,IL-35水平低于轻度感染组(P<0.05)。感染组术后2年的复发率高于未感染组,累积生存率低于未感染组(P<0.05)。ROC曲线分析结果显示,ET、PGRN、IL-35联合评估结直肠癌手术患者术后肺部感染的曲线下面积(AUC)为0.945,灵敏度为87.33%,特异性为92.41%,均优于各指标单独评估。结论 结直肠癌手术患者术后肺部感染会引起血清ET、PGRN水平升高及IL-35水平下降,导致不良预后,降低患者的生存周期,通过早期测定血清ET、PGRN、IL-35水平对结直肠癌手术患者术后合并肺部感染具有一定的评估价值,且三指标联合评估的效能更佳。 |
| 英文摘要: |
| Objective To analyze the effect of pulmonary infection on serum endotoxin (ET), granulin precursor (PGRN), interleukin-35 (IL-35) levels and prognosis in patients undergoing colorectal cancer surgery.Methods 150 patients with pulmonary infection after colorectal cancer surgery in our hospital from February 2021 to February 2022 were selected as the study group, and 145 patients without pulmonary infection after colorectal cancer surgery in our hospital during the same period were selected as the control group. According to the severity of pulmonary infection, the study group was divided into mild infection group (n=65) and moderate and severe infection group (n=85).Serum ET, PGRN, IL-35 levels were measured and compared between infection group and non-infection group.All patients were followed up for 2 years to observe the prognosis.Receiver operating curve (ROC) was used to analyze the value of combined detection of ET, PGRN and IL-35 in evaluating postoperative pulmonary infection in patients with colorectal cancer.Results The levels of ET and PGRN in serum of infected group were higher than those of non-infected group, IL-35 was lower than that of non-infected group (P<0.05), and the levels of ET and PGRN in serum of moderately and severely infected group were higher than those of lightly infected group, IL-35 was lower than that of lightly infected group (P<0.05).The recurrence rate of infection group was higher than that of non-infection group, and the cumulative survival rate was lower than that of non-infection group (P<0.05).ROC curve analysis showed that the area under the curve (AUC) of ET, PGRN and IL-35 in evaluating postoperative pulmonary infection in patients with colorectal cancer was 0.945, the sensitivity was 87.33%, and the specificity was 92.41%, which were better than those evaluated by each index alone.Conclusion Postoperative lung infection in patients with colorectal cancer can cause the increase of serum ET, PGRN and the decrease of IL-35, which leads to poor prognosis and reduces the survival cycle of patients. Early detection of serum ET, PGRN and IL-35 has certain evaluation value for postoperative lung infection in patients with colorectal cancer, and the efficacy of combined evaluation of three indexes is better. |
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