血MCP-1、PCT、免疫球蛋白在甲状腺癌患者术后感染并发症预测中的价值分析  

Value of Blood MCP-1,PCT and Immunoglobulin in Predicting Postoperative Infection Complications in Patients with Thyroid Cancer

作　　者：张元秋[1] 曾萍[1] 周彦生 白宾[1] 逯翘楚 薛会朝[1] ZHANG Yuanqiu;ZENG Ping;ZHOU Yansheng(The First Affiliated Hospital of Xinxiang Medical College,Xinxiang,453100)

机构地区：[1]新乡医学院第一附属医院,453100

出　　处：《实用癌症杂志》2021年第7期1181-1185,共5页The Practical Journal of Cancer

基　　金：河南省医学科技攻关计划项目(编号:2018010014)。

摘　　要：目的探讨血单核细胞趋化蛋白-1(MCP-1)、降钙素原(PCT)、免疫球蛋白在甲状腺癌患者术后感染并发症预测中的应用价值。方法选取甲状腺癌手术患者95例为研究对象,测定术前、术后1 d、术后3 d血MCP-1、PCT、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)水平,并依据患者术后有无感染并发症分为感染组(n=14)、未感染组(n=81),比较2组患者一般资料与术前、术后1 d、术后3 d血MCP-1、PCT、IgM、IgG、IgA水平,以受试者工作特征曲线(ROC)探讨其对患者术后是否发生感染并发症的预测价值,分析术后感染并发症影响因素。结果患者术后1 d、3 d血MCP-1、PCT水平较术前增高,血IgM、IgG、IgA水平较术前降低(P<0.05);组内比较,感染组与未感染组术后1 d、3 d血MCP-1、PCT高于术前,血IgM、IgG、IgA水平低于术前;组间比较,感染组术后1 d、3 d血MCP-1、PCT高于未感染组,血IgM、IgG、IgA水平低于未感染组(P<0.05)。术后3 d IgM预测甲状腺癌患者术后发生感染并发症AUC最大,为0.940,截断值为0.55 g/l,诊断敏感度为92.86%、特异度为86.42%;血MCP-1、PCT、IgM、IgG、IgA均为患者术后发生感染并发症的重要影响因素(P<0.05)。结论血清MCP-1、PCT、免疫球蛋白是引起甲状腺癌患者术后感染并发症的影响因素,监测其水平变化能早期预测术后感染并发症。Objective To investigate the application value of blood monocyte chemoattractant protein-1(MCP-1),procalcitonin(PCT)and immunoglobulin in the prediction of postoperative infection complications in patients with thyroid cancer.Methods 95 patients with thyroid cancer surgery were selected as subjects.The blood MCP-1,PCT and immunoglobulin M(IgM)were measured before,1 day and 3 days after operation.Immunoglobulin G(IgG)and immunoglobulin A(IgA)levels were divided into the infection group(n=14)and the uninfected group(n=81)according to the postoperative infection complications.The general data of patients were compared with the levels of MCP-1,PCT,IgM,IgG and IgA in the blood before operation,1 day after operation and 3 days after operation.The receiver operating characteristic curve(ROC)was used to investigate whether the patient developed infection after operation.Predictive value of the disease,analysis of factors affecting postoperative infection complications.Results The levels of MCP-1 and PCT in the blood increased 1 day and 3 days after operation,and the levels of IgM,IgG and IgA in blood decreased compared with those before operation(P<0.05).The infected group and the uninfected group were compared.The levels of blood MCP-1 and PCT were higher than those before operation at 1 d and 3 d.The levels of blood IgM,IgG and IgA were lower than those before operation.Compared with the group,the blood MCP-1 and PCT were higher than 1 day and 3 days after infection.In the infected group,the levels of blood IgM,IgG,and IgA were lower than those in the uninfected group(P<0.05).After 3 days,IgM predicted the maximum postoperative AUC of infection in patients with thyroid cancer,which was 0.940,and the cutoff value was 0.55 g/L.The sensitivity was 92.86% and the specificity was 86.42%.The blood MCP-1,PCT,IgM,IgG and IgA were all important factors influencing the postoperative infection complications(P<0.05).Conclusion Serum MCP-1,PCT and immunoglobulin are the influencing factors of postoperative infection complications i

关 键 词：甲状腺癌 MCP-1 PCT 免疫球蛋白 IgG IGM IgA 

分 类 号：R736.1[医药卫生—肿瘤]