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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.
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Objective:To investigate the significance of serum glycocholic acid (CG), total bile acid (TBA), and glucagon-like peptide-1 (GLP-1) in the transformation of fatty liver to liver cancer and their relationship with the body′s glucose and lipid metabolism.Methods:From May 2018 to August 2020, 96 patients with fatty liver (fatty liver group), 96 patients with liver cirrhosis (cirrhosis group) and 96 patients with liver cancer (liver cancer group) admitted to Jintang Hospital of West China Hospital of Sichuan University were selected. Ninety-six healthy physical examination patients were selected during the same period as the normal control group. Compared the general information, serum CG, TBA, GLP-1, glycosylated hemoglobin (HbA 1c), triacylglycerol (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) levels of each group. The correlation between serum CG, TBA, GLP-1 levels and the body′s glucose and lipid metabolism indicators were analyzed by Pearson correlation. The correlation between serum CG, TBA, GLP-1 and clinical stage were analyzed. Results:The levels of serum CG, TBA, GLP-1, and HbA 1c in the fatty liver group, cirrhosis group, liver cancer group were higher than those in the normal control group: (3.57 ± 1.06), (22.17 ± 8.44),(31.44 ± 9.65) mg/L vs. (1.26 ± 0.78) mg/L; (5.94 ± 1.26), (12.34 ± 4.02), (20.65 ± 5.17) μmol/L vs. (2.87 ± 0.59) μmol/L; (8.34 ± 1.55), (11.69 ± 3.26), (17.84 ± 2.78) pmol/L vs. (6.68 ± 1.24) pmol/L; (5.52 ± 0.31)%, (5.89 ± 0.27)%, (6.11 ± 0.23)% vs. (5.11 ± 0.36)%, and with the progression of the disease, the levels showed a rising trend, and the differences were statistically significant ( P<0.05). The levels of TG, TC, HDL-C, LDL-C in the cirrhosis group and liver cancer group were lower than those in the normal control group and fatty liver group, the differences were statistically significant ( P<0.05). The results of correlation analysis showed that serum CG, TBA, GLP-1 were positively correlated with HbA 1c ( P<0.05), and serum CG, TBA, GLP-1 were negatively correlated with TG, TC, HDL-C, and LDL-C ( P<0.05). With the increase of clinical stage, serum CG and TBA levels showed an increasing trend ( P<0.05). Conclusions:With the transformation of fatty liver to liver cancer, serum CG, TBA, and GLP-1 levels increase, and the change trend is closely related to the body′s glucose and lipid metabolism, which can provide a reference for the clinical improvement of fatty liver outcome evaluation mechanism.
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Objective:To investigate the level of hypersensitive C-reactive protein (hs-CRP) in serum of patients with non-small cell lung cancer (NSCLC), and to explore the relationship between hs-CRP level and clinical characteristics and prognosis.Methods:The clinical data of 96 patients with NSCLC (NSCLC group), 50 patients with benign lung disease (benign lung disease group) and 45 normal subjects (control group) from August 2015 to August 2019 were analyzed. The expression of hs-CRP in serum were detected by immunofluorescence immunoassay. The tumor markers carcino-embryonic antigen (CEA), carbohydrate antigen 125(CA125), cytokeratin-19 fragment antigen (Cyfra21-1), neuronspecific enolase (NSE)were measured using automatic biochemical immunoassay. The relationship between hs-CRP and age, gender, tumor pathological type, clinical stage, imaging relief in patients with NSCLC were analyzed. The sensitivity, specificity and accuracy of hs-CRP combined with CEA, CA125, Cyfra21-1 and NSE were calculated.Results:The levels of hs-CRP in NSCLC group and benign lung disease group were higher than that in control group [(14.9 ± 7.5), (26.4 ± 10.2) mg/L vs. (5.1 ± 1.3) mg/L], and the differences were statistically significant ( P<0.05 or <0.01); the level of hs-CRP in NSCLC group was lower than that in benign lung disease group [(14.9 ± 7.5) mg/L vs. (26.4 ± 10.2) mg/L], and the difference was statistically significant ( P<0.05). The levels of CEA, CA125, Cyfra21-1, NSE in NSCLC group were higher than that in benign lung disease group and control group, and there were significant differences ( P<0.01 or<0.05). In 96 patients with NSCLC, there was 49 patients with elevated hs-CRP (hs-CRP elevated group) and 47 patients with normal hs-CRP (hs-CRP normal group). Single factor analysis showed that the level of hs-CRP had no correlation with age, gender and tumor pathological type ( P>0.05), but had correlation with clinical stage ( P<0.05). After detecting the lesions by CT, the rate of solid tumors in hs-CRP elevated group was 66.0%, in hs-CRP normal group was 40.8%, and there was significant difference ( χ2 = 6.089, P<0.05).After followed up for 2 months in NSCLC patients, the disease control rate in hs-CRP elevated group was 59.6%, in hs-CRP normal group was 85.7%, and there was significant difference ( χ2 = 8.300, P<0.01). The ensitivity, specificity and accuracy of hs-CRP combined with CEA, CA125, Cyfra21-1 and NSE was 89.0%, 80.4% and 82.3%. Conclusions:Patients with NSCLC have high expression of hs-CRP, which is correlated with disease progression and clinical treatment. The indicator of hs-CRP combined with CEA, CA125, Cyfra21-1 and NSE may be important for diagnosis and prognosis of NSCLC.