乳腺癌是全球女性中最常见的诊断癌症。这些患者的主要治疗方法是手术。然而,乳腺癌患者手术部位感染(SSI)发生率较高.这项研究的目的是确定有效的感染相关诊断标志物,以及时诊断和治疗SSI。
这项回顾性研究包括2018年7月至2023年3月在山东省肿瘤医院和研究所接受治疗的263例乳腺癌患者。我们分析了SSI组和对照组之间的差异以及感染前和感染期间的差异。最后,我们测试了病原微生物的分布及其对抗生素的敏感性。
■与术前炎症指标相比,白细胞(WBC),中性粒细胞(NEU),绝对中性粒细胞计数与绝对淋巴细胞计数(NLR),D2聚合物(D-二聚体)和纤维蛋白原(FIB)显着增加,而淋巴细胞(LYM),SSI组白蛋白(ALB)和前白蛋白(PA)显著降低。与未感染患者相比,WBC,NEU,NLR和FIB显著增加,SSI患者ALB和PA显著降低,而LYM和D-二聚体没有显著差异。SSI患者感染细菌分布显示,金黄色葡萄球菌感染患者比例高达70.41%;其中,耐甲氧西林金黄色葡萄球菌(MRSA)感染占19.33%。WBC的受试者工作曲线(ROC)的曲线下面积(AUC),NEU,NLR,FIB,ALB和PA分别为0.807、0.811、0.730、0.705、0.663和0.796。其他炎症指标的AUC无统计学意义。与革兰氏阳性菌相比,金黄色葡萄球菌的抗生素耐药性没有显着差异。革兰阳性菌对头孢曲松(CRO)的耐药性,头孢西丁(福克斯),氯霉素(CHL),米诺环素(MNO)和四环素(TCY)低于革兰氏阴性菌,而对庆大霉素(GEN)的耐药性较高。
■这项研究表明,白细胞,NEU,NLR,FIB和PA对识别有SSI风险的患者具有良好的预测价值。炎症指标的截断值有助于SSI的预防和诊断。
Breast cancer is the most commonly diagnostic cancer in women worldwide. The main treatment for these patients is surgery. However, there is a high incidence of surgical site infection (
SSI) in breast cancer patients. The aim of this study was to identify effective infection-related diagnostic markers for timely diagnosis and treatment of
SSI.
This retrospective study included 263 breast cancer patients who were treated between July 2018 and March 2023 at the Shandong Cancer Hospital and Institute. We analyzed differences between the
SSI group and control group and differences before and during infection in the
SSI group. Finally, we tested the distribution of pathogenic microorganisms and their susceptibility to antibiotics.
Compared with preoperative inflammatory indicators, white blood cells (WBC), neutrophils (NEU), absolute neutrophil count to the absolute lymphocyte count (NLR), D2 polymers (D-Dimer) and fibrinogen (FIB) were significantly increased, while lymphocytes (LYM), albumin (ALB) and prealbumin (PA) were significantly decreased in the
SSI group. Compared with uninfected patients, WBC, NEU, NLR and FIB were significantly increased, ALB and PA were significantly decreased in SSI patients, while LYM and D-Dimer did not differ significantly. The distribution of infection bacteria in SSI patients showed that the proportion of patients with Staphylococcus aureus infection was as high as 70.41%; of those patients, 19.33% had methicillin-resistant Staphylococcus aureus (MRSA) infection. The area under the curves (AUCs) of the receiver operating curves (ROCs) for WBC, NEU, NLR, FIB, ALB and PA were 0.807, 0.811, 0.730, 0.705, 0.663 and 0.796, respectively. The AUCs for other inflammatory indicators were not statistically significant. There was no significant difference in antibiotic resistance for Staphylococcus aureus when compared to that of gram-positive bacteria. The resistance of gram-positive bacteria to ceftriaxone (CRO), cefoxitin (FOX), chloramphenicol (CHL), minocycline (MNO) and tetracycline (TCY) was lower than that of gram-negative bacteria, while the resistance to gentamicin (GEN) was higher.
This study demonstrated that WBC, NEU, NLR, FIB and PA have good predictive value for identifying patients at risk of SSI. The cut-off values of inflammatory indicators can be helpful in the prevention and diagnosis of
SSI.