摘要
目的探究宫颈癌患者外周血半胱氨酸天门冬氨酸蛋白水解酶-1(Caspase-1)、可溶性肿瘤坏死因子受体(STNFR)、辅助性T细胞(Th)1/Th2水平对术后感染的预测价值。方法选取2016年5月—2021年6月本院128例宫颈癌手术患者,根据术后是否发生感染分为感染组(n=40)与非感染组(n=88)。比较2组患者临床资料、手术前后外周血Caspase-1、STNFR、Th1/Th2水平,分析外周血Caspase-1、STNFR、Th1/Th2水平与临床分期的关系,绘制受试者工作特征曲线(ROC)评价外周血Caspase-1、STNFR、Th1/Th2水平对术后感染的预测价值,比较不同预后患者外周血Caspase-1、STNFR、Th1/Th2水平,分析外周血Caspase-1、STNFR、Th1/Th2水平与预后的关系,比较不同Caspase-1、STNFR、Th1/Th2水平宫颈癌患者生存情况。结果感染组患者临床分期Ⅰ期比例低于非感染组患者,差异有统计学意义(P<0.05);感染组患者术后外周血Caspase-1、STNFRⅠ、STNFRⅡ水平高于非感染组,Th1/Th2水平低于非感染组患者,差异有统计学意义(P<0.05);ROC曲线结果显示,宫颈癌患者术后外周血Caspase-1、STNFRⅠ、STNFRⅡ、Th1/Th2,四者联合评估术后感染的AUC为0.948,最佳敏感度为95.00%,特异度为81.82%,较四者单独预测价值高;logistic回归分析显示,Caspase-1、STNFRⅠ、STNFRⅡ、Th1/Th2水平均与宫颈癌患者预后独立相关(P<0.05);宫颈癌术后Caspase-1、STNFRⅠ、STNFRⅡ低水平患者住院28 d累积生存率高于高水平患者,Th1/Th2低水平患者生存率低于高水平患者(P<0.05)。结论宫颈癌术后感染外周血Caspase-1、STNFRⅠ、STNFRⅡ水平升高,Th1/Th2水平下降,临床检测其水平,有助于术后感染早期诊断及预后预测。
Objective To explore the predictive value of peripheral blood cysteine aspartate proteolytic enzyme-1(Caspase-1),soluble tumor necrosis factor receptor(STNFR),helper T cell(Th)1/Th2 levels in the postoperative infection of patients with cervical cancer.Methods A total of 128 patients undergoing cervical cancer surgery in our hospital from May 2016-June2021 were selected and divided into infected group(n=40)and non-infected group(n=88)according to whether infection occurred after surgery.The clinical data of the two groups of patients and the levels of Caspase-1,STNFR,Th1/Th2 in the peripheral blood before and after operations were compared,the relationship between the levels of Caspase-1,STNFR,Th1/Th2 in the peripheral blood and the clinical stage was analyzed,and the receiver operating characteristic curve(ROC)was drawn to evaluate the predictive value of peripheral blood Caspase-1,STNFR,Th1/Th2 levels for postoperative infection,compare peripheral blood Caspase-1,STNFR,Th1/Th2 levels in patients with different prognosis,and analyze the relationship between Caspase-1,STNFR,Th1/Th2 levels in peripheral blood and prognosis,and compare the survival of cervical cancer patients with different Caspase-1,STNFR,Th1/Th2 levels.Results The proportion of clinical stageⅠin the infected group was lower than that in the non-infected group,and the difference was statistically significant(P<0.05);the postoperative peripheral blood Caspase-1,STNFRⅠ,and STNFRⅡlevels in the infected group were higher than those in the non-infected group,the level of Th1/Th2 was lower than that of the non-infected group,and the differences were statistically significant(P<0.05);the ROC curve was drawn,and the results showed that the AUC of Caspase-1,STNFRⅠ,STNFRⅡ,and Th1/Th2 combined assessment in peripheral blood of patients with cervical cancer after surgery was 0.948,the best sensitivity was 95.00%,and the specificity was 81.82%,the predicting value of which was higher than that of any single item of the four;logistic regression analysis showed that Caspase-1,STNFRⅠ,STNFRⅡ,Th1/Th2 levels were independently correlated with the prognosis of cervical cancer patients(P<0.05);patients with low levels of Caspase-1,STNFRⅠ,and STNFRⅡafter cervical cancer surgery had a higher cumulative survival rate for 28 days in hospital than those with high levels,and the survival rate of patients with low Th1/Th2 level was lower than that of patients with high Th2 level(P<0.05).Conclusion The levels of Caspase-1,STNFRⅠ,and STNFRⅡin peripheral blood after cervical cancer infection are significantly increased,and Th1/Th2 levels are significantly decreased.Clinical detection of their levels is helpful for the early diagnosis and prognosis of postoperative infection.
作者
刘海青
李海洋
孙运明
杜玲
於军
LIU Hai-qing;LI Hai-yang;SUN Yun-ming;DU Ling;YU Jun(Department of Gynecology,Zhoushan Women and Children's Hospital,Zhoushan,Zhejiang 316000,China)
出处
《中国卫生检验杂志》
CAS
2022年第17期2087-2092,共6页
Chinese Journal of Health Laboratory Technology
基金
浙江省医药卫生科技计划项目(2021KY1174)。
