乳腺癌静脉输液港导管相关血流感染外周血CGRP、TM、PD-L1、PD-1表达及意义  

Expressions of CGRP,TM,PD-L1 and PD-1 in peripheral blood of breast cancer patients with venous access port-catheter-associated bloodstream infection and significance

作　　者：李强[1] 张玉智 武文慧 LI Qiang;ZHANG Yu-zhi;WU Wen-hui(Shengjing Hospital of China Medical University,Shenyang,Liaoning 110022,China)

机构地区：[1]中国医科大学附属盛京医院乳腺肿瘤外科,辽宁沈阳110022

出　　处：《中华医院感染学杂志》2024年第22期3432-3436,共5页Chinese Journal of Nosocomiology

基　　金：辽宁省卫生健康委员会基金资助项目(2022LK03210)。

摘　　要：目的探究乳腺癌静脉输液港导管相关血流感染外周血降钙素基因相关肽(CGRP)、血栓调节蛋白(TM)、细胞程序性死亡受体(PD)-配体1(L1)和PD-1表达及意义。方法选取中国医科大学附属盛京医院2021年2月-2023年2月收治的乳腺癌静脉输液港导管相关血流感染患者101例为感染组,据其感染程度分为轻、中和重度组,分别为29、33和39例;另随机选乳腺癌未发生静脉输液港导管相关血流感染患者103例为非感染组。统计感染组病原菌分布;比较不同组别间CGRP、TM、PD-L1、PD-1水平;分析四指标对乳腺癌静脉输液港导管相关血流感染诊断价值及与其感染程度相关性。结果101例感染组患者共检出病原菌113株,革兰阴性菌构成比最高。感染组CGRP、PD-L1水平低于非感染组,TM、PD-1水平高于非感染组(P<0.05)。中、重度组CGRP、PD-L1水平低于、TM、PD-1水平高于轻度组,且重度组水平变化高于中度组(P<0.05)。CGRP、PD-L1与乳腺癌静脉输液港导管相关血流感染程度呈负相关(P<0.05),TM、PD-1与其则呈正相关(P<0.05)。CGRP、TM、PD-L1、PD-1联合检测诊断乳腺癌静脉输液港导管相关血流感染曲线下面积(AUC)值高于各指标单一检测(P<0.05)。结论乳腺癌静脉输液港导管相关血流感染主要病原菌为革兰阴性菌,CGRP、TM、PD-L1、PD-1表达异常与其感染程度有关,四指标联合检测可提高其诊断价值。OBJECTIVE To explore the expressions of calcitonin gene-related peptide(CGRP),thrombomodulin(TM),programmed cell death receptor(PD)-ligand 1(L1)and PD-1 in the peripheral blood of the breast cancer patients with venous access port-catheter-associated bloodstream infection and analyze the significance.METHODS Totally 101 breast cancer patients with venous access port-catheter-associated bloodstream infection who were treated in Shengjing Hospital of China Medical University from Feb.2021 to Feb.2023 were assigned as the infection group and were divided into the mild group with 29 cases,the moderate group with 33 cases and the severe group with 39 cases.Meanwhile,103 breast cancer patients who did not have venous access port-catheter-associated bloodstream infection were chosen as the non-infection group.The distribution of pathogens isolated from the infection group was statistically analyzed.The levels of CGRP,TM,PD-L1 and PD-1 were compared among the groups.The values of the four indexes in diagnosis of the venous access port-catheter-associated infection and the association with the infection were observed.RESULTS Totally 113 strains of pathogens were isolated from the 101 patients of the infection group,among which gram-negative bacteria were dominant.The levels of CGRP and PD-L1 of the infection group were lower than those of the non-infection group,while the levels of TM and PD-1 of the infection group were higher than those of the non-infection group(P<0.05).The levels of CGRP and PD-L1 of the moderate group and the severe group were lower than those of the mild group,while the levels of TM and PD-1 of the moderate group and the severe group were higher than those of the mild group;the levels of the above indexes of the severe group were higher than those of the moderate group(P<0.05).The CGRP and PD-L1 were negatively associated with the severity of venous access port-catheter-associated bloodstream infection(P<0.05),while the TM and PD-1 were positively correlated with the infection(P<0.05).The area under

关 键 词：乳腺癌 静脉输液港 导管相关血流感染 降钙素基因相关肽 血栓调节蛋白 细胞程序性死亡受体-配体1 细胞程序性死亡受体-1 受试者工作特征曲线 诊断价值 

分 类 号：R737.9[医药卫生—肿瘤]