ABSTRACT
Objective:To investigate the changes in peripheral blood angiotensin-converting enzyme 2 (ACE2), high mobility group protein B1 (HMGB1) and interleukin 33 (IL-33) levels and their clinical significance in patients with primary lung cancer complicated by lung infection after surgery.Methods:The clinical data of 92 primary lung cancer patients treated at Longchang People′s Hospital from August 2018 to February 2021 were retrospectively collected, they were underwent radical lung cancer surgery, and were divided into the pulmonary infection group(27 cases) and the non-pulmonary infection group(65 cases) according to whether the patients had postoperative complications of pulmonary infection. The clinical data, peripheral blood ACE2, HMGB1 and IL-33 levels before and after surgery between the two groups were compared. The risk factors associated with postoperative pulmonary infection were analyzed by Lasso regression and Logistic regression. The predictive value of pulmonary infection was analyzed by receiver operating characteristic (ROC) curve. The cut-off values of peripheral blood ACE2, HMGB1 and IL-33 in the ROC curve were used as the boundary to divide the high level group and low level group, and the Kaplan-Meier survival curve was drawn to compare the survival rates of patients with high levels and low levels of peripheral blood ACE2, HMGB1 and IL-33.Results:The incidence of chronic obstructive pulmonary disease in the pulmonary infection group was higher than that in the non-pulmonary infection group: 40.74%(11/27) vs. 15.38%(10/65), there was statistical difference ( χ2 = 6.96, P<0.05). The levels of postoperative peripheral blood ACE2, HMGB1 and IL-33 in the pulmonary infection group were higher than those in the non-pulmonary infection group: (36.87 ± 9.87) mg/L vs. (25.94 ± 8.69) mg/L, (24.49 ± 8.14) μg/L vs. (16.74 ± 5.07) μg/L, (51.48 ± 8.25) ng/L vs. (39.88 ± 6.85) ng/L, there were statistical differences ( P<0.05). The results of Lasso regression and Logistic regression showed that the chronic obstructive pulmonary disease, postoperative peripheral blood ACE2, HMGB1 and IL-33 levels were independent risk factors for postoperative complications of pulmonary infection in patients with primary lung cancer ( P<0.05). The results of ROC curve showed that the area under the curve(AUC) values for postoperative peripheral blood ACE2, HMGB1 and IL-33 levels predicting postoperative complications of lung infection were 0.705, 0.821 and 0.768, respectively, and the AUC for the combination was 0.935. The risk of death in patients with high levels of postoperative peripheral blood ACE2, HMGB1 and IL-3 were 7.500, 4.874 and 2.857 times than the patients with low levels. Conclusions:Postoperative peripheral blood ACE2, HMGB1 and IL-3 levels in patients with primary lung cancer are important factors for pulmonary infection, which can be used for early prediction and evaluation after operation.
ABSTRACT
Objective To discuss the changes of serum gastric cancer associated antigen MG7 (MG7-Ag),carbohydrate antigen 125 (CA125) levels before and after chemotherapy in patients with advanced cervical cancer and their relationships with the curative effect.Methods A total of 150 advanced cervical cancer patients with paclitaxel combined with cisplatin treatment were selected from June 2014 to June 2017 in our hospital,and 150 cases of healthy persons were selected at the same time.The serum MG7-Ag and CA125 levels of all persons were detected.The differences of MG7-Ag and CA125 levels between healthy persons and advanced cervical cancer patients were analyzed.And the changes of MG7-Ag,CA125 levels before and after chemotherapy and the relationships between the MG7-Ag,CA125 levels and the curative effect of chemotherapy were analyzed.Results The serum MG7-Ag and CA125 levels in the patients with advanced cervical cancer were significantly higher than those in the healthy persons [(15.36 ±2.23) U/ml vs.(2.42 ±0.31) U/ml,(275.42 ± 30.52) U/ml vs.(1 1.89 ± 1.77) U/ml],and the differences were statistically significant (t =26.215,P ＜0.001;t =82.243,P ＜ 0.001).After chemotherapy for 150 patients with advanced cervical cancer,the complete remission (CR) was 5 cases (3.33％),the partial remission (PR) was 58 cases (38.67％),the stable disease (SD) was 60 cases (40.00％),and the progression disease (PD) was 27 cases (18.00％).The MG7-Ag and CA125 levels after chemotherapy in the patients with CR and PR were decreased significantly than those before chemotherapy [(7.12 ± 1.22) U/ml vs.(15.12 ± 3.32) U/ml,(180.34±22.42) U/mlvs.(274.21 ±30.82) U/ml,(9.22 ±1.77) U/mlvs.(15.52 ±3.53) U/ml,(206.75 ±23.02) U/ml vs.(276.12 ±30.92) U/ml],and the differences were statistically significant (t =5.057,P=0.001;t=12.150,P＜0.001,t =5.507,P＜0.001;t =13.705,P＜0.001).The MG7-Ag and CA125 levels after chemotherapy in the patients with PD were increased significantly than those before chemotherapy [(24.21 ± 3.64) U/ml vs.(15.56 ± 3.87) U/ml,(376.64 ± 45.12) U/ml vs.(280.75 ± 31.88) U/ml],and the differences were statistically significant (t =8.460,P ＜0.001;t =9.019,P ＜0.001).The MG7-Ag,CA125 levels after chemotherapy in the patients with SD were increased than those before chemotherapy [(16.01±2.37) U/mlvs.(15.67±3.55) U/ml,(285.26±37.34) U/mlvs.(277.04±31.73) U/ml],but the differences were not statistically significant (t =0.617,P =0.538;t =1.299,P =0.196).The results of receiver operatingcharacteristic (ROC) curve analysis showed that,in the aspect of sensitivity,specificity and accuracy of chemotherapy effect evaluation for cervical cancer,MG7-Ag decline percentage with ＞ 25％ as the critical value were 82.54％,82.76％,82.67％,CA125 decline percentage with ＞ 18％ as the critical value were 85.71％,86.21％,86.00％,and the combination of the two were 96.83％,97.70％,97.33 ％.The combination of the two were significantly higher than that of the two alone,and the differences were statistically significant (x2 =6.948,P =0.008;x2 =11.018,P =0.001;x2 =17.926,P ＜0.001;x2 =4.881,P =0.027;x2 =7.768 P =0.005;x2 =12.611,P ＜ O.001).Conclusion The serum MG7-Ag and CA125 levels in patients with advanced cervical cancer are higher than those in healthy persons.The MG7-Ag and CA125 levels of patients with CR and PR are decreased after chemotherapy,and their changes of serum levels can be used as the important indexes for evaluating the efficacy of chemotherapy.The combined detection of them has the better evaluation efficiency,and it is worth for further clinical promotion.