Predictive value of serum heparin binding protein, C-reactive protein and procalcitonin for pulmonary bacterial infection after video-assisted thoracoscopic surgery for lung cancer

doi:10.3877/cma.j.issn.1674-1358.2021.04.007

Abstract

Abstract:

Objective

To investigate the predictive value of serum heparin-binding protein (HBP), C-response protein (CRP), and procalcitonin (PCT) for pulmonary bacterial infection of patients with lung cancer after video assisted thoracoscopic surgery.

Methods

Clinical data of 105 patients with lung cancer admitted to Bozhou People’s Hospital from March 2017 to July 2020 were analyzed, retrospectively. The incidence rate of pulmonary bacterial infection of patients with lung cancer after VATS was analyzed. The patients were divided into infection group (18 cases) and control group (87 cases) according to whether occurred pulmonary bacterial infection after operation, and the levels of serum HBP, CRP and PCT were compared between the two group immediately and 24 hours after operation. The predictive value of change rates of serum HBP, CRP, PCT levels and the combination of the three indexes on pulmonary bacterial infection for patients with lung cancer after VATS were analyzed by receiver operating characteristic curve (ROC).

Results

The incidence rate of pulmonary infection after VATS was 17.14% (18/105). The levels of serum HBP, CRP and PCT of the two groups increased at 24 hours after operation compared with those immediately after operation, [Infection group: (12.52 ± 1.53) ng/ml vs. (8.16 ± 1.25) ng/ml; t = 9.363, P < 0.001. (41.83 ± 4.75) mg/ml vs. (21.68 ± 2.18) mg/ml; t = 16.357, P < 0.001. (1.21 ± 0.21) ng/ml vs. (0.32 ± 0.04) ng/ml; t = 17.663, P < 0.001. Control group: (9.94 ± 1.47) ng/ml vs. (7.91 ± 1.17) ng/ml; t = 10.078, P < 0.001. (31.62 ± 3.37) mg/ml vs. (21.27 ± 2.02) mg/ml; t = 24.571, P < 0.001. (0.65 ± 0.07) ng/ml vs. (0.34 ± 0.06) ng/ml; t = 31.363, P < 0.001], which were significantly higher of patients in infection group than those of control group (t = 6.732, 10.850, 20.282; all P < 0.001). The change rates of serum HBP, CRP and PCT of infection group were significantly higher than those of control group [(53.43 ± 6.82)% vs. (25.66 ± 4.51)%, (92.94 ± 8.73)% vs. (48.66 ± 6.12)%, (278.13 ± 34.75) % vs. (91.18 ± 10.36)%], with significant differences (t = 21.596, P < 0.001; t = 25.824, P < 0.001; t = 42.475, P < 0.001). ROC analysis on predicting pulmonary bacterial infection after VATS for patients with lung cancer showed that the best cut-off points of change rates of serum HBP, CRP and PCT were 32.93%, 71.65% and 128.75%, respectively. The area under curve (AUC) of the combined three indexes on predicting pulmonary bacterial infection after VATS was 0.848, which was higher than those of serum HBP (0.689), CRP (0.656) and PCT (0.612) (Z = 2.392, P = 0.017; Z = 2.601, P = 0.009; Z = 2.013, P = 0.048).

Conclusions

The increasing change rates of serum HBP, CRP and PCT levels of patients with pulmonary bacterial infection after VATS were higher than those of patients without pulmonary infection immediately and 24 hours after VATS. The combination of change rates of serum HBP, CRP and PCT levels was more suitable for predicting pulmonary bacterial infection of patients with lung cancer after VATS than those of single index.

Key words: Heparin binding protein, C-reactive protein, Procalcitonin, Lung cancer, Pulmonary bacterial infection, Postoperative complications, Video assisted thoracoscopy

Wei Wang, Kun Wang, Tao Sun, Yuhang Ru, Xiao Liu. Predictive value of serum heparin binding protein, C-reactive protein and procalcitonin for pulmonary bacterial infection after video-assisted thoracoscopic surgery for lung cancer[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2021, 15(04): 257-262.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsyhlcgrbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-1358.2021.04.007

https://zhsyhlcgrbzz.cma-cmc.com.cn/EN/Y2021/V15/I04/257

Figures/Tables 4

References 25

[1]	Mun M, Nakao M, Matsuura Y, et al. Video-assisted thoracoscopic surgery lobectomy for non-small cell lung cancer[J]. Gen Thorac Cardiovasc Surg,2018,66(11):626-631.
[2]	李波. 电视胸腔镜手术治疗原发性肺癌的疗效观察[J]. 中华肿瘤防治杂志,2018,25(1):71-72.
[3]	Houston KA, Mitchell KA, King J, et al. Histologic lung cancer incidence rates and trends vary by race/ethnicity and residential county[J]. J Thorac Oncol,2018,13(4):497-509.
[4]	唐小娟，侯思远，刘美，等. 肝素结合蛋白在感染性肺炎诊断中的价值分析[J]. 临床检验杂志,2020,38(1):66-69.
[5]	Stjärne Aspelund A, Hammarström H, Inghammar M, et al. Heparin-binding protein, lysozyme, and inflammatory cytokines in bronchoalveolar lavage fluid as diagnostic tools for pulmonary infection in lung transplanted patients[J]. Am J Transplant,2018,18(2):444-452.
[6]	杨思园，顾红岩，崔蓉. 外周血白细胞计数、淋巴细胞百分比和C-反应蛋白与呼吸道病毒检出率的相关性[J/CD]. 中华实验和临床感染病杂志(电子版),2018,12(6):565-569.
[7]	Ericksen RT, Guthrie C, Carroll T. The use of procalcitonin for prediction of pulmonary bacterial coinfection in children with respiratory failure associated with viral bronchiolitis[J]. Clin Pediatr (Phila),2019,58(3):288-294.
[8]	中华医学会，中华医学会肿瘤学分会，中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2018版)[J]. 中华肿瘤杂志,2018,40(12):935-964.
[9]	中华人民共和国卫生部. 医院感染诊断标准(试行)摘登(1)[J]. 新医学,2005,36(8):495-495.
[10]	Matsuoka K, Yamada T, Matsuoka T, et al. Video-assisted thoracoscopic surgery for lung cancer after induction therapy[J]. Asian Cardiovasc Thorac Ann,2018,26(8):608-614.
[11]	刘艳丽. PCT, hs-CRP, WBC及NEUT在肺部感染诊断中的临床价值[J]. 解剖学研究,2017,39(1):58-61.
[12]	Kerget B, Kerget F, Koçak AO, et al. Are serum interleukin 6 and surfactant protein D levels associated with the clinical course of COVID-19[J]. Lung,2020,198(5):777-784.
[13]	赖荣昌，莫松柳，莫凤兴. 参芪扶正注射液辅助治疗肺癌合并阻塞性肺部感染者的疗效及对血清细胞因子的影响[J/CD]. 中华实验和临床感染病杂志(电子版),2020,30(8):124-129.
[14]	张化芝，郭晓烨，李晓双，等. 肺癌术后并发肺部感染的病原学分析及影响因素分析[J]. 中华医院感染学杂志,2018,28(1):77-80.
[15]	Fisher J, Linder A, Bentzer P, et al. Is Heparin-binding protein inhibition a mechanism of albumin’s efficacy in human septic shock[J]. Crit Care Med,2018,46(5):e364-e374.
[16]	Higaki M, Shintani T, Hamada A, et al. Eldecalcitol (ED-71)-induced exosomal miR-6887-5p suppresses squamous cell carcinoma cell growth by targeting heparin-binding protein 17/fibroblast growth factor-binding protein-1 (HBp17/FGFBP-1)[J]. In Vitro Cell Dev Biol Anim,2020,56(3):222-233.
[17]	王志尚. C反应蛋白,中性粒细胞-淋巴细胞比率和血清白蛋白为基础的炎症预后指数对非小细胞肺癌预后作用的研究[J]. 临床肺科杂志,2018,23(1):160-164.
[18]	Karasahin O, Tasar PT, Timur O, et al. The value of C-reactive protein in infection diagnosis and prognosis in elderly patients[J]. Aging Clin Exp Res,2018,30(6):555-562.
[19]	段永强，余辉，王钢胜，等. 降钙素原对中晚期肺癌患者化疗期间感染的诊断效率[J/CD]. 中华实验和临床感染病杂志(电子版),2015,9(1):82-85.
[20]	Hovold G, Palmcrantz V, Kahn F, et al. Heparin-binding protein in sputum as a marker of pulmonary inflammation, lung function, and bacterial load in children with cystic fibrosis[J]. BMC Pulm Med,2018,18(1):104.
[21]	Kahn F, Tverring J, Mellhammar L, et al. Heparin-binding protein as a prognostic biomarker of sepsis and disease severity at the emergency department[J]. Shock,2019,52(6):e135-e145.
[22]	王彦，吴砚铭，王彦文，等. C反应蛋白/白蛋白比值与肺癌患者预后关系的Meta分析[J]. 华西医学,2019,34(1):50-57.
[23]	Shin WC, Do MU, Woo SH, et al. C-reactive protein for early detection of postoperative systemic infections in intertrochanteric femoral fractures[J]. Injury,2018,49(10):1859-1864.
[24]	Abedini A, Kiani A, Emami H, et al. Serum procalcitonin level as a predictor of bacterial infection in patients with COPD exacerbation[J]. Tanaffos,2019,18(2):112-117.
[25]	张敏，陈浩，曹明. 降钙素原检测在感染性疾病诊断中的价值[J/CD]. 中华实验和临床感染病杂志(电子版),2015,9(5):105-107.

一般资料		数值
性别[例（%）]
	男	63（60.00）
	女	42（40.00）
平均年龄（± s，岁）		48.65 ± 5.73
肺癌种类（周围型） [例（%）]		105（100.00）
肺癌病理类型[例（%）]
	腺癌	83（79.05）
	鳞癌	13（12.38）
	腺鳞癌	9（8.57）
肺癌分期[例（%）]
	Ⅰ期	73（69.52）
	Ⅱ期	32（30.48）
合并基础疾病[例（%）]
	高血压	27（25.71）
	糖尿病	21（20.00）
	脑血管病	6（5.71）
	其他	4（3.81）
饮酒史[例（%）]		55（52.38）
吸烟史[例（%）]		47（44.76）

一般资料		数值
性别[例（%）]
	男	63（60.00）
	女	42（40.00）
平均年龄（± s，岁）		48.65 ± 5.73
肺癌种类（周围型） [例（%）]		105（100.00）
肺癌病理类型[例（%）]
	腺癌	83（79.05）
	鳞癌	13（12.38）
	腺鳞癌	9（8.57）
肺癌分期[例（%）]
	Ⅰ期	73（69.52）
	Ⅱ期	32（30.48）
合并基础疾病[例（%）]
	高血压	27（25.71）
	糖尿病	21（20.00）
	脑血管病	6（5.71）
	其他	4（3.81）
饮酒史[例（%）]		55（52.38）
吸烟史[例（%）]		47（44.76）

检测指标	最佳截断点（%）	灵敏度（%）	特异度（%）	AUC	95%CI
血清HBP变化率	32.93	88.89（16/18）	59.77（52/87）	0.689	0.591~0.775
CRP变化率	71.65	83.33（15/18）	62.07（54/87）	0.656	0.557~0.746
PCT变化率	128.75	72.22（13/18）	72.41（63/87）	0.612	0.512~0.706
联合	—	72.22（13/18）	98.85（86/87）	0.848	0.765~0.911

检测指标	最佳截断点（%）	灵敏度（%）	特异度（%）	AUC	95%CI
血清HBP变化率	32.93	88.89（16/18）	59.77（52/87）	0.689	0.591~0.775
CRP变化率	71.65	83.33（15/18）	62.07（54/87）	0.656	0.557~0.746
PCT变化率	128.75	72.22（13/18）	72.41（63/87）	0.612	0.512~0.706
联合	—	72.22（13/18）	98.85（86/87）	0.848	0.765~0.911

Please choose a citation manager

Content to export