非小细胞肺癌患者介入术后外周血sCD14 IL-35与继发肺部感染的关系

doi:10.3969/j.issn.1006-6233.2026.01.021

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摘要 目的: 探讨非小细胞肺癌(NSCLC)患者介入术后外周血可溶性白细胞分化抗原14(sCD14)、白细胞介素-35(IL-35)水平与继发肺部感染的关系,并分析其对继发肺部感染的预测价值。方法: 选取2021年5月至2024年12月本院298例NSCLC患者,均行介入消融治疗,根据术后1周内是否继发肺部感染分为感染组、非感染组。采用倾向性评分匹配法分析两组一般资料。比较介入术前后外周血sCD14、IL-35、C反应蛋白(CRP)、降钙素原(PCT)水平。分析sCD14、IL-35水平与CRP、PCT的相关性。分析sCD14、IL-35与NSCLC患者继发肺部感染的线性关系。分析介入术后外周血sCD14、IL-35对NSCLC患者继发肺部感染的预测价值。结果: 298例NSCLC患者介入术后继发肺部感染42例(纳入感染组),其余256例纳入非感染组,采用倾向性评分匹配法处理后共匹配成功64例,其中感染组32例、非感染组32例;介入术后,感染组sCD14、CRP、PCT水平高于非感染组,IL-35水平低于非感染组(P<0.05);NSCLC介入术后继发肺部感染患者外周血sCD14水平与CRP、PCT呈正相关(r=0.665、0.686,P<0.05),IL-35水平与CRP、PCT呈负相关(r=-0.725、-0.777,P<0.05);平滑曲线拟合显示,介入术后外周血sCD14与NSCLC患者继发肺部感染风险呈线性正相关(P<0.05),IL-35与NSCLC患者继发肺部感染风险呈线性负相关(P<0.05);介入术后外周血sCD14、IL-35结合CRP、PCT综合预测NSCLC患者继发肺部感染的AUC值高达0.930,预测效能良好,具有明显增益价值(P<0.05)。结论: NSCLC患者外周血sCD14水平升高与介入术后继发肺部感染风险呈线性正相关,而IL-35水平降低与介入术后继发肺部感染风险呈线性负相关,介入术后外周血sCD14、IL-35结合CRP、PCT联合检测对继发肺部感染风险具有较高的预测价值。

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	高鹏飞
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关键词 ：非小细胞肺癌, 介入治疗, 微波消融, 可溶性白细胞分化抗原14, 白细胞介素-35, 肺部感染

Abstract：Objective: To investigate the relationship between the levels of soluble cluster of differentiation 14 (sCD14) and interleukin-35 (IL-35) in peripheral blood and secondary pulmonary infection in patients with non-small cell lung cancer (NSCLC) after interventional therapy, and to analyze their predictive value for secondary pulmonary infection. Methods: A total of 298 patients with NSCLC in our hospital from May 2021 to December 2024 were selected and treated with interventional ablation. According to whether there was secondary pulmonary infection within 1 week after operation, they were divided into infection group and non-infection group. The baseline data of the two groups were analyzed by propensity score matching. The levels of sCD14, IL-35, C-reactive protein (CRP) and procalcitonin (PCT) in peripheral blood before and after interventional therapy were compared. The correlation between the levels of sCD14, IL-35 and CRP, PCT was analyzed. The linear relationship between sCD14, IL-35 and secondary pulmonary infection in patients with NSCLC as well as the predictive value of peripheral blood sCD14 and IL-35 for secondary pulmonary infection in patients with NSCLC after interventional therapy were also analyzed. Results: Of 298 NSCLC patients undergoing interventional therapy, 42 cases of secondary pulmonary infection were enrolled in the infection group, and the remaining 256 cases were enrolled in the non-infection group. A total of 64 cases were successfully matched by propensity score matching, including 32 cases in the infection group and 32 cases in the non-infection group. After interventional therapy, the levels of sCD14, CRP and PCT in the infection group were higher than those in the non-infection group, while the level of IL-35 was lower than that in the non-infection group (P<0.05).After NSCLC interventional therapy,the level of sCD14 in peripheral blood of patients with secondary pulmonary infection was positively correlated with CRP and PCT (r=0.665, 0.686, P<0.05), while the level of IL-35 was negatively correlated with CRP and PCT (r=-0.725, -0.777, P<0.05). Smooth curve fitting showed that sCD14 in peripheral blood after interventional therapy was linearly and positively correlated with the risk of secondary pulmonary infection in NSCLC patients (P<0.05), while IL-35 was linearly and negatively correlated with the risk of secondary pulmonary infection in NSCLC patients (P<0.05). The AUC value of peripheral blood sCD14, IL-35 combined with CRP and PCT in predicting secondary pulmonary infection in NSCLC patients after interventional therapy was as high as 0.930(P<0.05), with good predictive efficacy and significant incremental value. Conclusion: The increase of sCD14 level in peripheral blood of NSCLC patients is linearly and positively correlated with the risk of secondary pulmonary infection after interventional therapy, while the decrease of IL-35 level is linearly and negatively correlated with the risk of secondary pulmonary infection after interventional therapy. Combined detection of sCD14, IL-35, CRP and PCT in peripheral blood after interventional therapy has high predictive value for the risk of secondary pulmonary infection.

Key words： Non-small cell lung cancer Interventional therapy Microwave ablation Soluble CD14 Interleukin-35 Lung infection

基金资助:2024年度长沙市自然科学基金项目,(编号:kq2502115);2024年度长沙市自然科学基金项目,(编号:kq2502037)

通讯作者: 舒升光

引用本文:

高鹏飞, 胡佳庆, 舒升光. 非小细胞肺癌患者介入术后外周血sCD14 IL-35与继发肺部感染的关系[J]. 河北医学, 2026, 32(1): 129-137.
GAO Pengfei, HU Jiaqing, SHU Shengguang. Relationship between Peripheral Blood sCD14 IL-35 and Secondary Pulmonary Infection in Patients with Non-small Cell Lung Cancer after Interventional Therapy. HeBei Med, 2026, 32(1): 129-137.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2026.01.021 或 http://www.hbyxzzs.cn/CN/Y2026/V32/I1/129

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