Objective To explore distribution of lower respiratory tract infection (LRTI) pathogens and the relationship between serum procalcitonin (PCT), interleukin-6 (IL-6), C-reactive protein (CRP) and disease severity, prognosis of patients with lung cancer and chronic obstructive pulmonary disease (COPD) after chemotherapy. Methods The clinical data were collected from 116 patients with lung cancer, COPD and LRTI after chemotherapy (infection group) between September 2022 and March 2024, while 50 patients with lung cancer, COPD and non-LRTI during the same period were enrolled as non-infection group. According to scores of acute physiology and chronic health evaluation II (APACHE II), patients in infection group were divided into mild-moderate group and severe group. The changes of PCT, IL-6 and CRP in different groups were observed. All patients in infection group were followed up for 3 months, and they were divided into death group and survival group according to prognosis. The predictive efficiency of serum PCT, IL-6 and CRP for prognosis of LRTI was evaluated by receiver operating characteristic (ROC) curves. Results The main pathogens of LRTI were Gram-negative bacteria (55.86%), Gram-positive bacteria (38.62%) and fungi (5.52%). The levels of PCT, IL-6 and CRP in infection group were higher than those in non-infection group (P<0.05). The levels of PCT, IL-6 and CRP in severe infection group were higher than those in mild-moderate infection group (P<0.05). The levels of serum PCT, IL-6 and CRP in death group were higher than those in survival group (P<0.05). Logistic regression analysis showed that PCT>5.133ng/mL, IL-6>52.630 pg/mL and CRP>87.949 mg/L were risk factors of poor prognosis (P<0.05). ROC curves analysis showed that sensitivity and specificity of serum PCT combined with IL-6 and CRP for evaluating prognosis of LRTI were higher (80.00%, 83.33%). Conclusion The distribution of LRTI pathogens is complex and diverse in patients with lung cancer and COPD after chemotherapy, and Gram-negative bacteria are the main pathogens. Serum PCT, IL-6 and CRP can be applied as important indexes to evaluate disease severity and prognosis.
Key words
lung cancer /
chronic obstructive pulmonary disease /
lower respiratory tract infection /
pathogen distribution /
disease severity
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