Dynamic changes and clinical significance of serum SAA, HMGB1 and sCD14 levels in lung cancer patients with postoperative pulmonary infection

Objective To explore the dynamic changes and clinical significance of serum amyloid A (SAA), high mobility protein 1 (HMGB1) and soluble CD14 (sCD14) levels in lung cancer patients with pulmonary infection. Methods A total of 130 lung cancer patients who underwent surgical treatment in the First People's Hospital of Shuangliu District of Chengdu from January 2019 to March 2021 were enrolled. According to the presence of pulmonary infection within 72 h after surgery, they were divided into two groups: an infected group and an uninfected group. Both groups were compared for clinical data, serum routine infection markers C-reactive protein (CRP) and procalcitonin (PCT), SAA, HMGB1, and sCD14. Multivariate Logistic regression analysis model was used to analyze the correlation between serum indicators and lung infections after lung cancer surgery. The Pearson correlation coefficient model was used to analyze the correlation between serum SAA, HMGB1, and sCD14 levels in the infection group and serum routine infection markers. The infection group received anti-infection treatment, and the treatment effect was calculated 7 days after treatment. Their levels of serum CRP, PCT, SAA, HMGB1 and sCD14 before treatment, 3 days, and 7 days after treatment were compared. The ROC curve was used to evaluate the application of serum CRP, PCT, SAA, HMGB1, and sCD14 to predict the treatment transition of lung infection. Results The infected group produced higher levels of serum CRP, PCT, SAA, HMGB1, and sCD14 than the uninfected group (P<0.05). Serum CRP, PCT, SAA, HMGB1, and sCD14 were significantly related to the occurrence of lung infection after lung cancer surgery (P<0.05). Serum SAA, HMGB1 and sCD14 in the infection group were positively correlated with CRP and PCT (P＜0.05). Serum CRP, PCT, SAA, HMGB1, and sCD14 levels of patients in the infection group with improved condition gradually decreased before treatment, 3 days, and 7 days after treatment, and they were all lower than those of unimproved patients (P＜0.05). The ROC curve showed that the combined predicted AUC was the largest, which was 0.969. Conclusions Lung cancer patients with postoperative pulmonary infection shows remarkable high levels of serum SAA, HMGB1 and sCD14 levels. With the improvement of infection, each indicators gradually decreased, and serum SAA, HMGB1 and sCD14 levels have certain value in predicting the prognosis of patients with lung infection. The combined application with serum routine infection markers can help improve the predictive value.