乳腺癌术后肺部感染危险因素及其外周血细胞因子的变化  

Risk factors for postoperative pulmonary infection in breast cancer patients and changes of peripheral blood cytokines

作　　者：卢艳[1] 李凡凡[1] 宋阿凤[1] 刘云 于孝辉 LU Yan;LI Fan-fan;SONG A-feng;LIU Yun;YU Xiao-hui(The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China;不详)

机构地区：[1]天津中医药大学第一附属医院乳腺外科,天津300193 [2]天津中医药大学研究生院,天津300193

出　　处：《中华医院感染学杂志》2020年第6期893-897,共5页Chinese Journal of Nosocomiology

基　　金：国家科技支撑计划基金资助项目(2007BAI20B043)。

摘　　要：目的探讨乳腺癌术后肺部感染的危险因素及其对外周血细胞因子的影响。方法回顾性分析2016年1月-2019年7月在天津中医药大学第一附属医院乳腺外科行乳腺癌改良根治术的170例患者,根据患者术后1个月内是否发生肺部感染,分为感染组32例和未感染组138例。记录患者年龄、吸烟史、联合放化疗、置管时间等特征。于术后24 h,检测血糖蛋白抗原(CA)153、CA125、特异性组织多肽抗原(TPS)、白介素(IL)-6、C-反应蛋白(CRP)、降钙素原(PCT)和循环肿瘤细胞(CTCs)水平;Logistic回归分析影响术后肺部感染的危险因素,Pearson分析危险因素与细胞因子之间的相关性。结果合并吸烟史(OR=1.755,P=0.036)、联合放化疗(OR=1.844,P=0.023)以及置管时间增加(OR=1.837,P=0.033)均为影响乳腺癌术后肺部感染的危险因素;感染组乳腺癌患者术后血CA153、CA125、TPS、IL-6、PCT、CRP水平和CTCs阳性率均高于未感染组(P<0.05);合并吸烟史、置管时间延长与血IL-6、CRP和PCT水平增加呈正相关(P<0.05),联合放化疗与血CA153、CA125、TPS、IL-6、CRP、PCT和CTCs水平增加呈正相关(P<0.05)。结论合并吸烟史、联合放化疗以及置管时间增加均为影响乳腺癌患者术后肺部感染的危险因素,可以影响术后血清肿瘤标志物和炎症因子水平变化。OBJECTIVE To explore the risk factors for postoperative pulmonary infection in breast cancer patients and their impact on peripheral blood cytokines. METHODS A total of 170 patients who underwent modified radical mastectomy in breast surgery department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from Jan 2016 to Jul 2019 were retrospectively analyzed, the enrolled patients were divided into the infection group with 32 cases and the non-infection group with 138 cases according to the fact whether the patients had pulmonary infection within 1 month after the surgery. The features such as age, smoking history, combined chemoradiotherapy and catheter indwelling time of the patients were recorded. The levels of carbohydrate antigen 153(CA153), CA125, tissue polypeptide specific antigen(TPS), interleukin-6(IL-6), C-reactive protein(CRP), procalcitonin(PCT) and circulating tumor cells(CTCs) were detected after the surgery for 24 hours. Logistic regression analysis was performed for the risk factors for the postoperative pulmonary infection, and the correlation between the risk factors and the cytokines was analyzed by means of Pearson analysis. RESULTS Complication with smoking history(OR=1.755,P=0.036), chemoradiotherapy(OR=1.844,P=0.023) and catheter indwelling time(OR=1.837,P=0.033) were the risk factors for the postoperative pulmonary infection in the breast cancer patients. The levels of serum CA153, CA125, TPS, IL-6, PCT and CRP as well as the positive rate of CTCs were significantly higher in the infection group than in the non-infection group after the surgery( P<0.05). The complication with smoking history and extension of catheter indwelling time were positively correlated with the elevation of levels of serum IL-6, CRP and PCT(P<0.05), the chemoradiotherapy was positively correlated with the elevation of levels of serum CA153, CA125, TPS, IL-6, CRP, PCT and CTCs(P<0.05). CONCLUSION Complication with smoking history, chemoradiotherapy and extension of catheter indwell

关 键 词：乳腺癌 肺部感染 肿瘤标志物 炎症因子 循环肿瘤细胞 

分 类 号：R737.9[医药卫生—肿瘤]