食管癌放化疗期间肺部感染病原菌分布及风险预测模型研究  

Study on pathogenic bacteria distribution and risk prediction model of pulmonary infection during radiotherapy and chemotherapy for esophageal cancer

作　　者：饶井芬 李富博[1] 肇爽[1] 张聪[1] 林萍萍[1] 朱彤[1] RAO Jingfen;LI Fubo;ZHAO Shuang;ZHANG Cong;LIN Pingping;ZHU Tong(Department of Oncology,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China)

机构地区：[1]承德医学院附属医院肿瘤科,河北承德067000

出　　处：《中国病原生物学杂志》2025年第5期592-596,共5页Journal of Pathogen Biology

摘　　要：目的探讨食管癌放化疗期间肺部感染病原菌分布及风险预测模型研究。方法选取2019年5月至2024年1月于本院接受放化疗治疗的食管癌患者360例作为研究对象,依据放化疗期间有无出现肺部感染分为感染组(n=45)和非感染组(n=315),采用Logistics回归分析影响肺部感染的危险因素,并构建综合指数;绘制受试者工作特征(ROC)曲线分析危险因素及综合指数预测肺部感染风险的AUC值、敏感度及特异度。结果45例食管癌并发肺部感染患者分离出56株病原菌,革兰阳性菌、革兰阴性菌、真菌分别占比22株(39.28%)、30株(53.57%)、3株(5.36%)。感染组和非感染组在年龄、糖尿病史、吸烟史、COPD史、临床分期、放疗时间、白蛋白等资料比较中,差异具有统计学意义(P<0.05)。单因素Logistic回归分析显示,年龄≥60岁、糖尿病史、吸烟史、COPD史、临床分期Ⅲ~Ⅳ期、放疗时间≥30 d、白蛋白<30 g/L是影响食管癌患者放化疗期间并发肺部感染的危险因素(P<0.05);多因素Logistic回归分析显示,年龄≥60岁、糖尿病史、吸烟史、临床分期Ⅲ~Ⅳ期、放疗时间≥30 d是影响食管癌患者放化疗期间并发肺部感染的独立危险因素(P<0.05)。ROC曲线分析显示,年龄≥60岁、糖尿病史、吸烟史、临床分期Ⅲ~Ⅳ期、放疗时间≥30 d及综合指数预测食管癌患者放化疗期间并发肺部感染的AUC值分别为0.606、0.595、0.602、0.600、0.578、0.737。结论年龄、糖尿病史、吸烟史、临床分期及放疗时间会对食管癌患者放化疗期间并发肺部感染产生不良影响,依据这些危险因素构建风险预测模型对预测肺部感染的发生具有重要意义。Objective To investigate the distribution of pathogenic bacteria and risk prediction model of pulmonary infection during radiotherapy and chemotherapy for esophageal cancer.Methods A total of 360 patients with esophageal cancer who received chemoradiotherapy in our hospital from May 2019 to January 2024 were selected as the study objects,and divided into infected group(n=45)and non-infected group(n=315)according to whether there was lung infection during chemoradiotherapy.Logistics regression was adopted to analyze the risk factors affecting lung infection,and a comprehensive index was constructed.Receiver Operating characteristic(ROC)curve was drawn to analyze the AUC value,sensitivity and specificity of risk factors and composite index to predict the risk of pulmonary infection.Results Fifty-six strains of pathogenic bacteria were isolated from 45 patients with esophageal cancer complicated with pulmonary infection.Gram-positive bacteria,gram-negative bacteria and fungi accounted for 22(39.28%),30(53.57%)and 3(5.36%).There were significant differences in age,diabetes history,smoking history,COPD history,clinical stage,radiotherapy time and albumin between the infected group and the non-infected group(P<0.05).Univariate Logistic regression analysis showed that age≥60 years old,diabetes history,smoking history,COPD history,clinical stage Ⅲ-Ⅳ,radiotherapy duration≥30 d,albumin<30 g/L were the risk factors for pulmonary infection during radiotherapy and chemotherapy in patients with esophageal cancer(P<0.05).Multivariate Logistic regression analysis showed that age≥60 years old,diabetes history,smoking history,clinical stage Ⅲ-Ⅳ,and radiotherapy duration≥30 d were independent risk factors for pulmonary infection during radiotherapy and chemotherapy in patients with esophageal cancer(P<0.05).ROC curve analysis showed that the AUC values of patients aged≥60 years,diabetes history,smoking history,clinical stage Ⅲ-Ⅳ,radiotherapy duration≥30 d and composite index predicting pulmonary infection du

关 键 词：食管癌 放化疗 肺部感染 病原菌分布 风险预测模型 

分 类 号：R735.1[医药卫生—肿瘤]