A Study on The Significance of Serum Cith3 and nCD64 Index Detection in Patients with Lung Infection Complicated During Chemotherapy for Lung Cancer

ZHANG Zhongyuan; CHI Xidi; YE Guiyun; FAN Renliang; ZHANG Shaohong

doi:10.3639/j.issn.2095-3097.2025.08.021

Abstract：Objective To detect the levels of serum citrullinated histone H3(CitH3)and neutrophil CD64(nCD64)index in patients with lung cancer who developed lung infections during chemotherapy,and to analyze their clinical significance.Methods Clinical data were retrospectively collected from January 2020 to December 2023 at Fujian Medical University Affiliated Nanping First Hospital,including 80 lung cancer patients with lung infection during chemotherapy(infected group)and 80 lung cancer patients without infection during the same period(uninfected group).The clinical data and serum CitH3 levels and nCD64 index were compared between the two groups.Multivariate logistic regression was used to analyze the influencing factors for lung infection complicating chemotherapy in lung cancer patients.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the value of serum CitH3 and nCD64 index in the early diagnosis of lung infection.Kaplan-Meier survival curves were used to assess the prognostic value of serum CitH3 and nCD64 index.Pathogenic bacteria were isolated and identified in the infected group.Results A total of 106 strains of pathogenic bacteria related to lung infection were isolated from the 80 patients,including 49 Gram-negative strains(46.23%),36 Gram-positive strains(33.96%),and 21 fungal strains(19.81%).Statistically significant differences(P<0.05)were observed between the infected and uninfected groups in the proportion of smoking history,chemotherapy regimen,TNM stage,chemotherapy cycles,serum CitH3 levels,and nCD64 index.Multivariate logistic regression analysis showed that multi-drug combination chemotherapy,smoking history,TNM stageⅢ-Ⅳ,chemotherapy cycles≥2,and elevated serum CitH3 levels and nCD64 index were influencing factors for lung infection complicating chemotherapy in lung cancer patients(P<0.05).ROC curve analysis revealed that the AUC for predicting lung infection using serum CitH3,nCD64 index,and their combination were 0.846(95%CI:0.783-0.909),0.855(95%CI:0.783-0.927),and 0.921(95%CI:0.878-0.963),respectively.Kaplan-Meier survival curve analysis showed that the survival rates of the high CitH3 and high nCD64 index groups were significantly lower than those of their respective low-level groups(P<0.05).Conclusion Serum CitH3 levels and nCD64 index were significantly elevated in lung cancer patients with lung infections complicating chemotherapy compared to uninfected patients.Detection of these levels aids in the early diagnosis and prognostic assessment of lung infections complicating lung cancer chemotherapy.