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| Etiological Characteristics of Pulmonary Infection in Patients Undergoing Chemotherapy for Advanced Lung Cancer and the Predictive Value of HMGB1 Combined with MMP-9 |
| ZHANG Hongpei, JIN Faguang, REN Teng |
| The Second Affiliated Hospital of Air Force Military Medical University, Shaanxi Xi'an 710038, China |
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Abstract Objective: To investigate the etiological characteristics of pulmonary infection in patients undergoing chemotherapy for advanced lung cancer and the predictive value of high mobility group box 1 (HMGB1) combined with matrix metalloproteinase-9 (MMP-9). Methods: A total of 118 patients who underwent chemotherapy for advanced lung cancer in the Second Affiliated Hospital of Air Force Medical University from June 2023 to June 2024 were selected, and divided into the infected group (n=51) and the uninfected group (n=67) based on whether they developed pulmonary infection after chemotherapy. Sputum samples were collected from the infected group for etiological examination. The levels of HMGB1 and MMP-9 in the two groups were compared. Logistic regression analysis was performed to identify factors influencing pulmonary infection in patients undergoing chemotherapy for advanced lung cancer. The receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of HMGB1 combined with MMP-9 levels for pulmonary infection. Results: In this study, 51 patients developed pulmonary infection. A total of 64 strains of pathogenic bacteria were isolated, including 39 strains (60.94%) of Gram-negative bacteria, 20 strains (31.25%) of Gram-positive bacteria, and 5 strains (7.81%) of fungi. The levels of HMGB1 and MMP-9 in the infected group were higher than those in the uninfected group (P<0.05). Logistic regression analysis showed that HMGB1 and MMP-9 levels were risk factors for pulmonary infection (P<0.05). The area under the curve (AUC), sensitivity and specificity of HMGB1 were 0.806, 56.86% and 94.03% (P<0.05). The AUC, sensitivity and specificity of MMP-9 were 0.838, 62.75% and 92.54% (P<0.05). The AUC, sensitivity and specificity of HMGB1 combined with MMP-9 were 0.905, 72.55% and 92.54% (P<0.05). Conclusion: Gram-negative bacteria are main pathogenic bacteria of pulmonary infection in patients undergoing chemotherapy for advanced lung cancer. The levels of HMGB1 and MMP-9 are significantly elevated in patients with pulmonary infection. Combination of HMGB1 and MMP-9 can improve clinical diagnostic efficacy for pulmonary infection in patients undergoing chemotherapy for advanced lung cancer.
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2025, Vol. 31 
