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目的探讨降钙素原和淀粉样蛋白A在乳腺癌患者手术切口感染中的诊断价值。方法收集2013年1月-2016年6月浙江省肿瘤医院乳腺外科和浙江大学附属第二医院肿瘤外科收治的乳腺癌切除术患者456例,根据患者术后是否发生切口感染,将患者分为感染组和非感染组,其中感染组23例,非感染组433例。比较两组患者降钙素原、淀粉样蛋白A、C反应蛋白、白细胞和白蛋白水平。结果与非感染组比较,感染组患者降钙素原显著增加(P=0.000),淀粉样蛋白A显著增加(P=0.000),C反应蛋白显著增加(P=0.000),白细胞显著增加(P=0.000)。两组患者白蛋白水平比较,差异无统计学意义(P>0.05)。ROC曲线显示降钙素原、淀粉样蛋白A、C反应蛋白和白细胞在预测乳腺癌患者术后切口感染中的曲线下面积分别为0.858(0.731~0.979)、0.866(0.772~0.959)、0.682(0.552~0.812)和0.678(0.566~0.790),两组比较,差异有统计学意义(P<0.05)。结论降钙素原和淀粉样蛋白A在预测乳腺癌患者术后切口感染中具有较好的应用价值。
Objective To investigate the value of procalcitonin and amyloid A in the diagnosis of surgical incision infection in patients with breast cancer. Methods 456 cases of breast cancer resected from Department of Breast Surgery, Zhejiang Tumor Hospital and the Second Affiliated Hospital of Zhejiang University from January 2013 to June 2016 were divided into two groups according to whether incision infection occurred after operation or not, Group and non-infected group, of which 23 cases of infection, 433 cases of non-infected group. The levels of procalcitonin, amyloid A, C-reactive protein, leukocyte and albumin were compared between the two groups. Results Compared with non-infected group, procalcitonin significantly increased (P = 0.000), amyloid A significantly increased (P = 0.000), C-reactive protein increased significantly (P = 0.000) = 0.000). There was no significant difference in albumin levels between the two groups (P> 0.05). ROC curve showed that the area under the curve of procalcitonin, amyloid A, C-reactive protein and white blood cells in predicting incision infection in patients with breast cancer were 0.858 (0.731-0.979), 0.866 (0.772-0.9595) and 0.682 0.552 ~ 0.812) and 0.678 (0.566 ~ 0.790), the difference between the two groups was statistically significant (P <0.05). Conclusions Procalcitonin and amyloid A have a good value in predicting wound infection in patients with breast cancer.