老年胃癌根治术后肺部感染IL-33和Th1/Th2表达及意义  

Clinical significance of IL-33 and Th1/Th2 in elderly gastric cancer patients with pulmonary infection after radical surgery

作　　者：李晓君[1] 李新丽[2] 胡佳扬 胡筱壮[4] 徐金利 LI Xiao-jun;LI Xin-li;HU Jia-yang;HU Xiao-zhuang;XU Jin-li(Puyang People's Hospital,Puyang,Henan 457000,China)

机构地区：[1]濮阳市人民医院手术室,河南濮阳457000 [2]濮阳市人民医院普外科,河南濮阳457000 [3]濮阳市人民医院消化二科,河南濮阳457000 [4]濮阳市人民医院胃肠外科,河南濮阳457000

出　　处：《中华医院感染学杂志》2021年第14期2189-2192,共4页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划基金资助项目(201802209)。

摘　　要：目的探讨老年胃癌根治术后肺部感染患者白细胞介素(IL)-33和辅助性T细胞(Th)1/Th2表达及意义。方法选取2016年1月-2019年12月于濮阳市人民医院行胃癌根治术治疗患者180例,统计患者术后肺部感染发生情况,并根据患者术后是否发生肺部感染将其分为感染组、非感染组,比较两组患者术后IL-33与Th1/Th2细胞免疫应答变化,采用受试者工作特征曲线(ROC)分析相关因子对胃癌根治术后肺部感染的预测价值。结果180例行胃癌根治术治疗患者术后肺部感染25例(13.89%),感染组中年龄(≥65岁)比率高于非感染组,术后留置胃管时间、手术时间、住院时间长于非感染组,术中出血量大于非感染组(均P<0.05),且IL-6、红细胞沉降率(ESR)、C-反应蛋白(CRP)、IL-33、IL-4、白细胞(WBC)水平高于非感染组(P<0.05),而干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-ɑ)、Th1/Th2、淋巴细胞比例低于非感染组(P<0.05);ROC曲线分析结果显示IL-33、IFN-γ、IL-4、Th1/Th2曲线下面积(AUC)分别为0.832、0.828、0.789、0.868,Cut-off分别50.085 pg/ml、30.415 pg/ml、21.845 pg/ml、1.605。结论胃癌根治术后肺癌感染患者的IL-33水平升高,而Th1/Th2降低,并且IL-33、IFN-γ、IL-4、Th1/Th2对胃癌根治术后肺癌感染具有良好的预测效能。OBJECTIVE To explore clinical significance of interleukin(IL)-33 and helper T cells(Th)1/Th2 in elderly gastric cancer patients with pulmonary infection after radical surgery.METHODS Totally 180 gastric cancer patients who received radical surgery in Puyang People’s Hospital from Jan 2016 to Dec 2019 were enrolled in the study.The incidence of postoperative pulmonary infection was statistically analyzed,the patients were divided into the infection group and the non-infection according to the status of postoperative pulmonary infection.The IL-33 and Th1/Th2 cellular immune response were compared between the two groups of patients after the surgery,and the values of the related factors in prediction of the postoperative pulmonary infection were analyzed by using receiver operating characteristic(ROC)curve.RESULTS Among the 180 gastric cancer patients who underwent the radical surgery,25(13.89%)had postoperative pulmonary infection.The proportion of the patients with no less than 65 years of age was higher in the infection group than in the non-infection group.The gastric tube indwelling time,operation duration and length of hospital stay of the infection group were significantly longer than those of the non-infection group,and the intraoperative blood loss volume of the infection group was significantly more than that of the non-infection group(all P<0.05);the levels of IL-6,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),IL-33,IL-4 and white blood cell(WBC)of the infection group were significantly higher than those of the non-infection group(P<0.05),while the levels of interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-ɑ),Th1/Th2 and percentage of lymphocytes of the infection group were significantly lower than those of the non-infection group(P<0.05).ROC curve analysis showed that the areas under curves(AUCs)of the IL-33,IFN-γ,IL-4 and Th1/Th2 were respectively 0.832,0.828,0.789 and 0.868;the Cut-off values were respectively 50.085 pg/ml,30.415 pg/ml,21.845 pg/ml and 1.605.CONCLUSION The IL-33 lev

关 键 词：胃癌根治术 术后肺部感染 白细胞介素-33 辅助性T细胞 临床意义 

分 类 号：R735.2[医药卫生—肿瘤]