子宫内膜癌术后医院感染风险模型及PD-1+CD3+、CA125、YKL-40的预测价值

Risk model of postoperative nosocomial infection in patients with endometrial cancer and predictive values of PD-1+CD3+, CA125 and YKL-40

    摘要
  • 摘要: 目的 探究子宫内膜癌术后感染危险因素并构建预测模型,分析程序性死亡受体-1(PD-1)+CD3+、糖类抗原125(CA125)、甲壳质酶蛋白40(YKL-40)对感染的预测价值。方法 选取2019年1月-2022年8月吉安市妇幼保健院收治的181例子宫内膜癌患者纳入研究,根据患者术后感染情况将其分为感染组34例,未感染组147例。单因素及多因素分析子宫内膜癌术后感染的危险因素并建立危险因素Logistic回归方程,绘制受试者工作特征(ROC)曲线分析PD-1+CD3+、CA125、YKL-40对子宫内膜癌术后感染的预测价值。结果 181例子宫内膜癌患者术后感染34例,感染率为18.78%; 多因素Logistic分析结果显示,国际妇产科联盟(FIGO)分期Ⅱ期、手术方式开腹、血清白蛋白(ALB)水平<30g/L为子宫内膜癌患者术后感染的危险因素(P＜0.05); 根据危险因素构建Logistic回归方程:Logit(P)=-8.257+FIGO分期×1.196+手术方式×1.288+血清ALB水平×2.287,ROC曲线分析显示,PD-1+CD3+、CA125、YKL-40预测子宫内膜癌术后感染的曲线下面积(AUC)分别为0.804、0.737、0.800。结论 子宫内膜癌术后感染发生率较高, FIGO分期Ⅱ期、手术方式开腹、血清ALB水平<30 g/L与子宫内膜癌术后感染的发生息息相关,PD-1+CD3+、CA125、YKL-40对子宫内膜癌术后感染均具有一定预测价值。

     

    Abstract: OBJECTIVE To explore the prediction for postoperative infection in patients with endometrial cancer, establish risk factor model, and analyze the values of programmed death receptor-1 (PD-1) +CD3+, carbohydrate antigen 125 (CA125) and chitinase protein 40 (YKL-40) in prediction of the infection. METHODS Totally 181 patients with endometrial cancer who were treated in Ji'an Maternal and Child Health Hospital from Jan 2019 to Aug 2022 were enrolled in the study and were divided into the infection group with 34 cases and the no infection group with 147 cases according to the status of postoperative infection. Univariate analysis and multivariate analysis were performed for risk factors for the postoperative infection, the logistic regression equation of risk factors was established, and the values of PD-1+CD3+, CA125 and YKL-40 in prediction of postoperative infection were analyzed by means of receiver operating characteristic (ROC) curves. RESULTS Of the 181 patients with endometrial cancer, 34 had postoperative infection, with the infection rate 18.78%. The result of multivariate logistic analysis showed that International Federation of Gynecology and Obstetrics (FIGO) stage Ⅱ, open laparotomy and serum albumin (ALB) level less than 30g/L were the risk factors for the postoperative infection in the patients with endometrial cancer(P＜0.05). Logistic regression equation was established based on the risk factors: Logit(P)=-8.257+FIGO stage×1.196+ surgery mode×1.288+ serum ALB level×2.287. ROC analysis indicated that the areas under curves (AUCs) of PD-1+CD3+, CA125 and YKL-40 were respectively 0.804, 0.737 and 0.800 in prediction of postoperative infection in the patients with endometrial cancer. CONCLUSION The incidence of postoperative infection is high among the patients with endometrial cancer. The occurrence of postoperative infection is closely associated with FIGO stage Ⅱ, laparotomy and serum albumin level less than 30g/L; PD-1+CD3+, CA125 and YKL-40 have certain values in prediction of the postoperative infection in the patients with endometrial cancer.

     

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