Department of Anesthesiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Chinese Academy of Sciences, Sichuan Translational Medicine Research Hospital, Chengdu, China.
Ann Palliat Med. 2021 Apr;10(4):4502-4508. doi: 10.21037/apm-21-554.
To analyze the predictive value of postoperative C-reactive protein (CRP), procalcitonin (PCT), and triggering receptor expressed on myeloid cells 1 (TREM-1) for the early detection of pulmonary infection following laparoscopic general anesthesia for cervical cancer treatment.
We enrolled 80 patients who underwent radical surgery for cervical cancer in our hospital from March 2018 to March 2020 and divided them into an infected group (n=34) and non-infected group (n=46) according to whether they were complicated by lung infection after surgery. The levels of CRP, PCT, and TREM-1 were compared between the two groups, and logistic regression was used to analyze the risk factors for pulmonary infection. The ROC curve was used to analyze the predictive value of the individual detection of CRP, PCT, or TREM-1 as well as their combined detection.
The levels of CRP, PCT, and TREM-1 in the infected group were higher than those in non-the infected group 24 h after operation (P<0.05) and tumor TNM staging, previous lung disease, postoperative use of a ventilator, intraoperative use of antibacterial drugs, PCT, CRP, and ICAM-1 were significantly correlated with pulmonary infection (P<0.05). The postoperative application of a ventilator, PCT (increasing), CRP (increasing), and ICAM-1 (increasing) were all individual factors that could affect the development of pulmonary infection (P<0.05). ROC curve results showed that the critical score of combined detection was 3.026, and the area under the curve (AUC) was 0.786 (0.637-0.935), the sensitivity was 90.52%, and the specificity was 89.63%.
The levels of PCT, CRP, and TREM-1 are abnormally increased in patients with pulmonary infection after laparoscopic general anesthesia for cervical cancer treatment. Their combined detection can be used as an effective means to predict the occurrence of pulmonary infections in the early stage and their level should direct timely intervention to improve the prognosis of patients.
分析术后 C 反应蛋白(CRP)、降钙素原(PCT)和髓系细胞触发受体 1(TREM-1)对腹腔镜全麻治疗宫颈癌术后肺部感染的早期预测价值。
选取 2018 年 3 月至 2020 年 3 月在我院行根治性手术的宫颈癌患者 80 例,根据术后是否并发肺部感染分为感染组(n=34)和非感染组(n=46)。比较两组 CRP、PCT、TREM-1 水平,采用 logistic 回归分析肺部感染的危险因素。采用 ROC 曲线分析 CRP、PCT、TREM-1 单项检测及联合检测的预测价值。
术后 24 h 感染组 CRP、PCT、TREM-1 水平高于非感染组(P<0.05);肿瘤 TNM 分期、既往肺部疾病史、术后使用呼吸机、术中使用抗菌药物、PCT、CRP、ICAM-1 与肺部感染显著相关(P<0.05)。术后使用呼吸机、PCT(升高)、CRP(升高)、ICAM-1(升高)均为影响肺部感染发生的独立因素(P<0.05)。ROC 曲线结果显示,联合检测的临界值为 3.026,曲线下面积(AUC)为 0.786(0.637~0.935),灵敏度为 90.52%,特异度为 89.63%。
腹腔镜全麻治疗宫颈癌术后并发肺部感染患者 PCT、CRP、TREM-1 水平异常升高,联合检测可作为预测肺部感染早期发生的有效手段,其水平应指导及时干预,改善患者预后。