Department of Clinical Laboratory, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Front Cell Infect Microbiol. 2023 Oct 25;13:1286313. doi: 10.3389/fcimb.2023.1286313. eCollection 2023.
Breast cancer is the most commonly diagnostic cancer in women worldwide. The main treatment for these patients is surgery. However, there is a high incidence of surgical site infection (SSI) in breast cancer patients. The aim of this study was to identify effective infection-related diagnostic markers for timely diagnosis and treatment of SSI.
This retrospective study included 263 breast cancer patients who were treated between July 2018 and March 2023 at the Shandong Cancer Hospital and Institute. We analyzed differences between the SSI group and control group and differences before and during infection in the SSI group. Finally, we tested the distribution of pathogenic microorganisms and their susceptibility to antibiotics.
Compared with preoperative inflammatory indicators, white blood cells (WBC), neutrophils (NEU), absolute neutrophil count to the absolute lymphocyte count (NLR), D2 polymers (D-Dimer) and fibrinogen (FIB) were significantly increased, while lymphocytes (LYM), albumin (ALB) and prealbumin (PA) were significantly decreased in the SSI group. Compared with uninfected patients, WBC, NEU, NLR and FIB were significantly increased, ALB and PA were significantly decreased in SSI patients, while LYM and D-Dimer did not differ significantly. The distribution of infection bacteria in SSI patients showed that the proportion of patients with infection was as high as 70.41%; of those patients, 19.33% had methicillin-resistant (MRSA) infection. The area under the curves (AUCs) of the receiver operating curves (ROCs) for WBC, NEU, NLR, FIB, ALB and PA were 0.807, 0.811, 0.730, 0.705, 0.663 and 0.796, respectively. The AUCs for other inflammatory indicators were not statistically significant. There was no significant difference in antibiotic resistance for when compared to that of gram-positive bacteria. The resistance of gram-positive bacteria to ceftriaxone (CRO), cefoxitin (FOX), chloramphenicol (CHL), minocycline (MNO) and tetracycline (TCY) was lower than that of gram-negative bacteria, while the resistance to gentamicin (GEN) was higher.
This study demonstrated that WBC, NEU, NLR, FIB and PA have good predictive value for identifying patients at risk of SSI. The cut-off values of inflammatory indicators can be helpful in the prevention and diagnosis of SSI.
乳腺癌是全球女性最常见的诊断癌症。这些患者的主要治疗方法是手术。然而，乳腺癌患者中手术部位感染（SSI）的发生率很高。本研究旨在确定有效的感染相关诊断标志物，以便及时诊断和治疗 SSI。
本回顾性研究纳入了 2018 年 7 月至 2023 年 3 月在山东省肿瘤医院和研究所接受治疗的 263 例乳腺癌患者。我们分析了 SSI 组和对照组之间的差异，以及 SSI 组在感染前后的差异。最后，我们检测了致病菌的分布及其对抗生素的敏感性。
与术前炎症指标相比，白细胞（WBC）、中性粒细胞（NEU）、中性粒细胞计数与淋巴细胞计数比值（NLR）、D2 聚体（D-Dimer）和纤维蛋白原（FIB）显著升高，而淋巴细胞（LYM）、白蛋白（ALB）和前白蛋白（PA）显著降低。与未感染患者相比，SSI 患者的 WBC、NEU、NLR 和 FIB 显著升高，ALB 和 PA 显著降低，而 LYM 和 D-Dimer 无显著差异。SSI 患者感染细菌的分布显示，金黄色葡萄球菌感染的患者比例高达 70.41%；其中 19.33%的患者感染了耐甲氧西林金黄色葡萄球菌（MRSA）。WBC、NEU、NLR、FIB、ALB 和 PA 的受试者工作特征曲线（ROC）下面积（AUCs）分别为 0.807、0.811、0.730、0.705、0.663 和 0.796。其他炎症指标的 AUC 无统计学意义。与革兰阳性菌相比，金黄色葡萄球菌对头孢曲松（CRO）、头孢西丁（FOX）、氯霉素（CHL）、米诺环素（MNO）和四环素（TCY）的耐药性较低，而对庆大霉素（GEN）的耐药性较高。
本研究表明，WBC、NEU、NLR、FIB 和 PA 对识别 SSI 风险患者具有良好的预测价值。炎症指标的截断值有助于 SSI 的预防和诊断。
