CD64指数联合L-1β、TLR4在诊断结直肠癌患者术后感染中的临床价值
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安徽省铜陵市卫生健康委员会医学科研项目(卫科研[2021]3号)


Value of CD64 index combined with IL-1β and TLR4 in the diagnosis of postoperative infection of colorectal cancer
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    摘要:

    摘要:目的探讨 CD64指数联合血清白细胞介素-1β(IL-1β)、Toll样受体4(TLR4)在诊断结直肠癌患者术后切口感染中的.临床应用价值。方法以 2020年6月至2022年6月收治入院的113例行结直肠癌根治术患者作为研究对象,根据其术后是 否发生切口感染,分为感染组与非感染组。分别于术前、术后3d及术后5 d检测外周血CD64指数及血清IL-1B、TLR4水平,绘制ROC曲线并分析各指标单独及联合应用时诊断结直肠癌术后切口感染的临床应用价值,以及三者与患者切口感染严重 程度之间的关系。结果术后3d及 术后5d,感染组患者CD64指数以及血清IL-1β .TLR4水平均高于非感染组;术后3d,感染组患者CD64指数、血清IL-1β及TLR4水平均较术前明显上升;术后5d,感染组各指标均较术后3d有所下降,但依旧高于术前水平,差异均具有统计学意义(P<0.05)。非感染组患者术前、术后3d以及术后5d CD64指数JL-1β、TLR4水平差异均无统计学意义(P>0.05)。以术后3d作为预测结直肠癌术后感染的时间点绘制各指标的ROC曲线,结果发现CD64指数、血清IL-1β、TLR4单独及三者联合应用预测结直肠癌术后感染的AUCROC分别为0.937、0.901、0.790及0.997( 95% CI:0.992~1.000),各指标单独应用能较好地预测结直肠癌术后感染,三者联合应用的预测效能最高。结论外周 血CD64指数、血清IL-1β .TLR4在预测结直肠癌术后切口感染中具有良好效能,三者联合应用的预测效能最高,可作为临床筛查术后感染的早期预测指标。

    Abstract:

    Abstract: Objective To explore the value of CD64 index combined with senum interleukin-1β ( IL1β) and Toll-like receptor 4 ( TLR4) levels in the diagnosis of postoperative incision infection in patients undergoing colorectal cancer surgery. Methods A total of 113 patients undergoing radical resection of colorectal cancer in our hospital from June 2020 to June 2022 were enrolled as the study subjects. They were divided into infected group and non-infected group according to whether incision infection occurred after surgery.Peripheral blood CD64 index and the levels of serum IL-1β and TLR4 were detected before surgery and 3 and 5 days after surgery. The receiver operating characteristic ( ROC) curve was drawn to analyze the value of each indicator and their combination in the diagnosis of postoperative incision infection of colorectal cancer and the relationship between three indicators and severity of incision infection.Results On the 3" and 5" days after surgery , the CD64 index and levels of serum IL-1β and TLR4 in the infected group were higher than those in the non-infected group, and the three indicators in the infected group on the 3" day after surgery were significantly in- creased compared with those before surgery. The three indicators in the infected group on the 5" day after surgery were decreased compared with those on the 3" day after surgery , but they were still higher than those before surgery , with statistical differences ( P<0.05). There were no significant differences in CD64 index and serum IL-1β and TLR4 levels in the non-infected group before surgery and on the 3" and 5" days after surgery (P>0.05 ). The ROC curve drawn with each indicator on the 3" day ater surgery showed that the areas under the ROC curve ( AUCROC ) of CD64 index, serum IL-1β and TLR4, and their combination in predicting the postoperative infection of colorectal cancer were 0.937, 0.901, 0.790, and 0.997 ( 95% CI: 0.992-1 .00) , respectively ,indicating that each indicator a- lone could better predict the postoperative infection of colorectal cancer, and the combination of the three indicators might have the best predictive efciency. Conclusion Peripheral blood CD64 index and serum IL-1β and TLR4 levels have good fficiency in predicting the postoperative incision infection of colorectal cancer, and their combined application has the hi ghest predictive efficiency, which can be used as early predictors for the clinical screening of postoperative infection.

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张盛,崇慧峰,焦瑞宝,周萍. CD64指数联合L-1β、TLR4在诊断结直肠癌患者术后感染中的临床价值[J].临床检验杂志,2024,42(03):177-181

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  • 收稿日期:2023-08-07
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  • 在线发布日期: 2024-05-09
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