血清sCD14联合sCD30对肺癌患者合并肺部真菌感染的诊断价值

Diagnostic value of serum sCD14 combined with sCD30 for pulmonary fungal infection in lung cancer patients

摘要:

目的 探讨血清人可溶性白细胞分化抗原14（sCD14）联合sCD30对肺癌患者合并肺部真菌感染的诊断价值。方法 回顾性分析2021年3月—2024年4月在浙江中医药大学附属杭州市中医院和福建医科大学附属第一医院接受治疗的126例肺癌患者的病历资料，根据是否合并肺部真菌感染分为合并组24例和非合并组102例。比较两组患者血清sCD14、sCD30水平及肿瘤标志物［癌胚抗原（CEA）、糖类抗原（CA-125）、细胞角蛋白19片段（CYFRA21-1）、神经元特异性烯醇化酶（NSE）］水平，检查两组患者的肺功能指标［第1秒用力呼气容积（FEV₁）、分钟最大通气量（MVV）、最大呼气中段流量（MMF）］，分析血清sCD14、sCD30对肺癌患者合并肺部真菌感染的影响及诊断价值。结果 合并组sCD14、sCD30水平均高于非合并组（P <0.05）。两组患者血清CEA、CA-125、CYFRA21-1、NSE水平比较，差异均无统计学意义（P >0.05）。合并组FEV₁、MVV、MMF水平均低于非合并组（P <0.05）。多因素逐步Logistic回归分析结果显示：血清sCD14水平高［O^R=3.691（95% CI：1.335，10.201）］和sCD30水平高［O^R=3.579（95% CI：1.294，9.899）］均是肺癌患者合并肺部真菌感染的危险因素（P <0.05）。受试者工作特征曲线分析结果显示，血清sCD14、sCD30及两者联合诊断肺癌患者合并肺部真菌感染的曲线下面积分别为0.734（95% CI：0.599，0.865）、0.712（95% CI：0.576，0.848）、0.851（95% CI：0.754，0.948）；敏感性分别为82.4%（95% CI：0.740，0.952）、67.1%（95% CI：0.591，0.756）、89.5%（95% CI：0.784，0.973）；特异性分别为64.1%（95% CI：0.585，0.738）、79.2%（95% CI：0.709，0.946）、72.5%（95% CI：0.631，0.842）。结论 血清sCD14、sCD30表达升高与肺癌患者合并肺部真菌感染有关，血清sCD14、sCD30可用于辅助诊断肺癌患者合并肺部真菌感染，诊断效能良好。

Abstract:

Objective To explore the diagnostic value of serum soluble cluster of differentiation (sCD) 14 combined with sCD30 for pulmonary fungal infection in lung cancer patients.Methods A retrospective analysis was conducted on the medical records of 126 lung cancer patients who received treatment at Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University and the First Affiliated Hospital of Fujian Medical University from March 2021 to April 2024. The patients were divided into a combined group of 24 cases and a non-combined group of 102 cases based on whether they had concomitant pulmonary fungal infections. The serum levels of sCD14 and sCD30, as well as tumor markers such as carcinoembryonic antigen (CEA), carbohydrate antigen-125 (CA-125), cytokeratin 19 fragment (CYFRA21-1), and neuron-specific enolase (NSE), were compared between two groups of patients. The lung function indicators of the two groups of patients, including forced expiratory volume in 1 second (FEV1), maximum minute ventilation (MVV), and maximum mid expiratory flow (MMF) were determined. The effect and diagnostic value of serum sCD14 and sCD30 on pulmonary fungal infections in lung cancer patients were analyzed.Results The levels of sCD14 and sCD30 in the combined group were higher than those in the non-combined group (P < 0.05). The comparison of serum CEA, CA-125, CYFRA21-1, and NSE levels between the combined and non-combined groups showed no statistically significant differences (P > 0.05). FEV1, MVV and MMF in the combined group were all higher than those in the non-combined group (P < 0.05). The multivariable stepwise Logistic regression analysis revealed that serum sCD14 levels [O^R = 3.691 (95% CI: 1.335, 10.201)] and sCD30 levels [O^R = 3.579 (95% CI: 1.294, 9.899)] were both risk factors for pulmonary fungal infections in lung cancer patients (P < 0.05). The receiver operating characteristic (ROC) curve analysis demonstrated that the areas under curves of serum sCD14 and sCD30 levels and their combination for diagnosing pulmonary fungal infection in lung cancer patients were 0.734 (95% CI: 0.599, 0.865), 0.712 (95% CI: 0.576, 0.848) and 0.851 (95% CI: 0.754, 0.948), with the sensitivities being 82.4% (95% CI: 0.740, 0.952), 67.1% (95% CI: 0.591, 0.756), and 89.5% (95% CI: 0.784, 0.973), and the specificities being 64.1% (95% CI: 0.585, 0.738), 79.2% (95% CI: 0.709, 0.946), and 72.5% (95% CI: 0.631, 0.842), respectively.Conclusions Elevated levels of serum sCD14 and sCD30 are associated with pulmonary fungal infection in lung cancer patients. Serum sCD14 and sCD30 can be used to assist in the diagnosis of pulmonary fungal infection in lung cancer patients with good diagnostic efficacy.