肺癌合并肺部感染病原学特点及其血清TNF-α、IL-1β及IL-6水平检测价值分析  

Etiological characteristics and detection value of serum TNF-α,IL-1βand IL-6 in lung cancer combined with lung infection

作　　者：郭淑娟 韩吉香 姜文青[3] GUO Shujuan;HAN Jixiang;JIANG Wenqing(Department of Integrated Traditional Chinese and Western Medicine,qingdao university,Qingdao,Shandong,China,266071;Department of Respiratory and Critical Care Medicine,Yangguang Harmony Hospital,Weifang,Shandong,China,261000;Department of Respiratory,Qingdao Haici Medical Group,Qingdao,Shandong,China,266000)

机构地区：[1]青岛大学中西医结合医学科,山东青岛266071 [2]阳光融和医院呼吸与危重医学科,山东潍坊261000 [3]青岛海慈医疗集团呼吸科,山东青岛266000

出　　处：《分子诊断与治疗杂志》2023年第12期2109-2112,共4页Journal of Molecular Diagnostics and Therapy

基　　金：山东省科技厅自然科学基金项目(ZR2022HL108)。

摘　　要：目的探讨肺癌合并肺部感染患者的病原学特征、血清炎症因子水平变化及其临床意义。方法收集2022年5月至2023年5月阳光融和医院收治的49例非小细胞肺癌(NSCLC)合并肺部感染患者设为感染组,选取同期未合并感染的52例NSCLC患者设为非感染组。采集空腹静脉血检测两组肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)及白细胞介素-6(IL-6)水平;采用ROC曲线评价TNF-α、IL-1β及IL-6对NSCLC合并肺部感染的诊断效能。结果49例NSCLC合并肺部感染患者中,咳嗽咳痰34例(69.39%),发热32例(65.31%),白细胞计数升高14例(28.57%),中性粒细胞计数增高30例(61.22%),胸片及CT示散在小片状阴影34例(69.39%)、大片状阴影7例(14.29%);共培养分离出病原菌58株,其中革兰阳性菌13株(22.41%),革兰阴性菌38株(65.52%),真菌和结核杆菌7株(12.07%)。感染组明显高于非感染组,差异有统计学意义(P<0.05)。TNF-α、IL-1β及IL-6三者联合诊断NSCLC合并肺部感染的AUC分别大于IL-1β和TNF-α单项诊断NSCLC合并肺病感染的AUC(P<0.05),与IL-6单项诊断NSCLC合并肺部感染的AUC比较差异无统计学意义(P>0.05)。结论NSCLC合并肺部感染临床表现不典型,呼吸道症状不明显,以革兰阴性菌感染为主;患者血清TNF-α、IL-1β及IL-6水平明显升高,联合检测此三项指标有助于鉴别诊断NSCLC合并肺部感染。Objective To explore etiological characteristics,changes and clinical significance of serum inflammatory factors in patients with lung cancer and lung infection.Methods A total of 49 patients with non-small cell lung cancer(NSCLC)and lung infection and 52 NSCLC patients without lung infection in Yangguang Harmony Hospital were enrolled as the infection group and the non-infection group between May 2022 and May 2023.Fasting venous blood was collected to detect levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and interleukin-6(IL-6).The diagnostic efficiency of TNF-α,IL-1βand IL-6 for NSCLC combined with lung infection was evaluated by the receiver operating characteristic(ROC)curves.Results Among the 49 patients with NSCLC and lung infection,there were 34 cases(69.39%)with cough and expectoration,32 cases(65.31%)with fever,14 cases(28.57%)with increased white blood cell count and 30 cases(61.22%)with increased neutrophil count.X-ray and CT showed that there were 34 cases(69.39%)with small patchy shadows and 7 cases(14.29%)with large patchy shadows.There were 58 strains of pathogens,including 13 strains(22.41%)of Gram-positive bacteria,38 strains(65.52%)of Gram-negative bacteria and 7 strains(12.07%)of fungi and Mycobacterium tuberculosis.The levels of serum TNF-α,IL-1βand IL-6 in the infection group were significantly higher than those in the non-infection group(P<0.05).The AUC of TNF-αcombined with IL-1βand IL-6 in the diagnosis of NSCLC combined with lung infection was greater than that of IL-1βand TNF-αalone(P<0.05),but there was no significant difference in the AUC between IL-6 and combined detection(P>0.05).Conclusion The clinical manifestations of NSCLC combined with lung infection are atypical,and the respiratory symptoms are not significant.Gram-negative bacteria infection is in the majority.The levels of serum TNF-α,IL-1βand IL-6 in patients are significantly increased.The combined detection of the three indicators is conductive to differential diagnosis of NSCLC combined with l

关 键 词：肺癌 肺部感染 病原学特征 肿瘤坏死因子-α 白细胞介素-1Β 白细胞介素-6 

分 类 号：R734.2[医药卫生—肿瘤] R563.1[医药卫生—临床医学]