hs-CRP、WBC、PCT鉴别肺癌患者感染性发热与癌性发热的价值  

The value of hs-CRP,WBC and PCT in identifying infection fever and cancerous fever in patients with lung cancer

作　　者：杨富涛[1] 王俊刚 李伟[1] YANG Fu-tao;WANG Jun-gang;LI Wei(Department of Thoracic Surgery,Nanyang Central Hospital,Nanyang,Henan 473009,China)

机构地区：[1]南阳市中心医院胸外科,河南南阳473009

出　　处：《热带医学杂志》2021年第9期1151-1153,1157,共4页Journal of Tropical Medicine

基　　金：国家自然科学基金青年科学基金项目(81502023)。

摘　　要：目的探讨超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)和白细胞计数(WBC)在肺癌患者感染性发热与癌性发热的诊断价值。方法回顾分析在南阳市中心医院2015年1月-2018年10月进行血清hs-CRP、WBC以及PCT检测的132例肺癌患者的临床及实验室资料,根据感染的情况和相关检验将患者分为局部感染组(n=33)、全身感染组(n=64)、癌性发热组(n=35),比较三组患者血清中hs-CRP、WBC以及PCT水平,采用受试者工作特征曲线比较hs-CRP、WBC、PCT鉴别肺癌患者感染性发热和癌性发热的诊断价值。结果全身感染组患者的PCT、hs-CRP及WBC水平均显著高于癌性发热组和局部感染组,而局部感染组患者的PCT、hs-CRP及WBC水平显著高于肿瘤发热组,差异均有统计学意义(P<0.05)。PCT单独诊断癌性发热和感染性发热时曲线下面积(0.907)、敏感度(95.33%)、特异度(95.37%)均优于hs-CRP、WBC,差异有统计学意义(P<0.05);PCT、hs-CRP、WBC联合诊断的曲线下面积(0.934)、敏感度(97.21%)、特异度(96.55%)更优于PCT,差异有统计学意义(P<0.05)。结论在诊断感染性发热和癌性发热中,PCT相较于WBC以及hs-CRP更具有诊断价值,三者联合诊断效果更优。Objective To investigate the diagnostic value of high-sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT)and white blood cell count(WBC)in the treatment of infection fever and cancerous fever in patients with lung cancer.Methods The clinical and laboratory data of 132 patients with lung cancer who were tested for serum hs-CRP,WBC and PCT from January 2015 to October 2018 in Nanyang Central Hospital were retrospectively analyzed.The patients were divided into three groups:local infection group(n=33),systemic infection group(n=64)and cancerous fever group(n=35).The serum levels of hs-CRP,WBC and PCT were compared among the three groups.Levels and receiver curve were used to compare the value of hs-CRP,WBC,PCT in the differential diagnosis of infectious fever and cancerous fever in lung cancer patients.Results The levels of PCT,hs-CRP and WBC in the systemic infection group were significantly higher than those in the cancerous fever group and the local infection group,while the levels of PCT,hs-CRP and WBC in the local infection group were significantly higher than those in the cancerous fever group,and the differences were statistically significant(P<0.05).The area under the curve(0.907),sensitivity(95.33%),and specificity(95.37%)of PCT alone diagnosed cancerous fever and infection fever were better than hs-CRP and WBC,and the difference was statistically significant(P<0.05);Area under the curve(0.934),sensitivity(97.21%),and specificity(96.55%)of combined diagnosis of PCT,hs-CRP,and WBC were better than PCT,and the difference was statistically significant(P<0.05).Conclusion In the diagnosis of fever and cancerous fever,PCT had more diagnostic value than WBC and hs-CRP,and the combined diagnosis of the three should be better.

关 键 词：超敏C反应蛋白 白细胞计数 降钙素原 癌性发热 局部感染发热 全身感染发热 

分 类 号：R734.2[医药卫生—肿瘤]