摘要
目的分析肺癌患者肺部病原菌感染情况及患者血清中相关肿瘤标志物水平变化,并探讨其临床意义。方法 2015年7月-2018年1月本院收治的肺癌伴肺部感染患者80例(为感染组),同期入院的无肺癌伴肺部感染患者80例(为对照组)。采集感染组患者痰标本,采用全自动细菌鉴定仪检测病原菌种类及分布情况;采集患者血标本,采用全自动化学发光免疫分析仪检测比较两组患者血清中糖类抗原-153(carbohydrate antigen-153,CA153)、糖类抗原-199(carbohydrate antigen-199,CA199)及癌胚抗原(carcinoembryonic antigen,CEA)水平,分析其与肺癌癌症类型及分期的关系。结果 80例肺癌伴肺部感染患者共分离出病原菌118株。包括革兰阴性菌71株(占60.17%)、革兰阳性菌35株(占29.67%)、真菌12株(占10.17%)。感染组患者血清中CA153、CA199及CEA水平分别为(73.39±7.68) U/mL、(128.66±13.59) U/mL和(16.61±1.72) ng/mL,对照组分别为(7.24±0.63) U/mL、(8.62±1.07) U/mL和(2.12±0.24) ng/mL(t_1=76.782;t_2=78.761;t_3=74.627,P<0.05)。按组织类型分组,腺癌组患者血清中CA153、CA199及CEA水平显著高于小细胞癌组及鳞癌组(t_(1小)=16.344;t_(2小)=9.392;t_(3小)=19.855;t_(1鳞)=10.698;t_(2鳞)=6.306;t_(3鳞)=12.501,P<0.05)。对肺癌患者进行TNM分期,Ⅲ-Ⅳ期患者血清CA153、CA199及CEA水平显著高于Ⅰ-Ⅱ期(t_1=26.085;t_2=12.905;t_3=23.775,P<0.05)。结论肺癌患者肺部感染致病菌以革兰阴性菌占多数;患者血清中CA153、CA199及CEA水平升高,可作为肺癌的诊断指标,且对肺癌类型及癌细胞扩散、转移程度的判定有指导意义。
Objective To analyze the prevalence of pathogens in patients with lung cancer and a pulmonary infection,to detect the levels of related tumor markers in patient sera,and to explore the clinical significance of those levels.Methods Eighty patients with lung cancer and a pulmonary infection seen at this Hospital from July 2015-January 2018 served as patients with an infection.Eighty patients without lung cancer or a pulmonary infection who were seen at this Hospital during the same period served as the control group.The distribution of pathogens in patients with an infection was analyzed.The levels of carbohydrate antigen-153(CA153),carbohydrate antigen-199(CA199),and carcinoembryonic antigen(CEA) in patients in the two groups were compared.The relationship between the levels of those indicators and the type or stage of lung cancer was analyzed.Results In total,118 strains of pathogens were isolated from 80 patients with lung cancer and a pulmonary infection,including 71 strains of Gram-negative bacteria accounting for 60.17%,35 strains of Gram-positive bacteria accounting for 29.67%,and 12 strains of fungi accounting for 10.17%.The serum levels of CA153,CA199,and CEA in patients with an infection were 73.39±7.68 U/mL,128.66±13.59 U/mL,and 16.61±1.72 ng/mL,and the serum levels of CA153,CA199,and CEA in the control group were 7.24±0.63 U/mL,8.62±1.07 U/mL,and 2.12±0.24 ng/mL(t1=76.782;t2=78.761;t3=74.627,P<0.05).The serum levels of CA153,CA199,and CEA in patients with adenocarcinoma were significantly higher than those in patients with small cell carcinoma or squamous cell carcinoma(t1=16.344;t2=9.392;t3=19.855;t1=10.698;t2=6.306;t3=12.501,P<0.05).The serum levels of CA153,CA199,and CEA in patients with stage III-IV lung cancer were significantly higher than those in patients with stage I-II lung cancer(t1=26.085;t2=12.905;t3=23.775,P<0.05).Conclusion The main pathogens causing a pulmonary infection in patients with lung cancer were Gram-negative bacteria.The levels of CA153,CA199,and CEA in the sera of patien
作者
易金远
陈宏明
罗世官
农峰
覃雪梅
YI Jin-yuan;CHEN Hong-ming;LUO Shi-guan;NONG Feng;QIN Xue-mei(Thoracic and Cardiovascular Surgery;Respiratory Medicine,The Hospital Affiliated with Youjiang Medical College for Na-tionalities,Baise,Guangxi,China 533000)
出处
《中国病原生物学杂志》
CSCD
北大核心
2019年第3期354-357,共4页
Journal of Pathogen Biology
基金
广西医药卫生科研课题(No.Z2011143)
广西高校桂西地区高发病防治研究重点实验室开放课题(右医科字2015 [2]号)
关键词
肺癌
肺部感染
病原菌
肿瘤标志物
Lung cancer
pulmonary infection
pathogens
tumor markers
