Diagnostic value of inflammatory indicators for surgical site infection in patients with breast cancer.

Background: Breast cancer is the most commonly diagnostic cancer in women worldwide. The main treatment for these patients is surgery. However, there is a high incidence of surgical site infection (SSI) in breast cancer patients. The aim of this study was to identify effective infection-related diagnostic markers for timely diagnosis and treatment of SSI. Methods: This retrospective study included 263 breast cancer patients who were treated between July 2018 and March 2023 at the Shandong Cancer Hospital and Institute. We analyzed differences between the SSI group and control group and differences before and during infection in the SSI group. Finally, we tested the distribution of pathogenic microorganisms and their susceptibility to antibiotics. Results: Compared with preoperative inflammatory indicators, white blood cells (WBC), neutrophils (NEU), absolute neutrophil count to the absolute lymphocyte count (NLR), D2 polymers (D-Dimer) and fibrinogen (FIB) were significantly increased, while lymphocytes (LYM), albumin (ALB) and prealbumin (PA) were significantly decreased in the SSI group. Compared with uninfected patients, WBC, NEU, NLR and FIB were significantly increased, ALB and PA were significantly decreased in SSI patients, while LYM and D-Dimer did not differ significantly. The distribution of infection bacteria in SSI patients showed that the proportion of patients with Staphylococcus aureus infection was as high as 70.41%; of those patients, 19.33% had methicillin-resistant Staphylococcus aureus (MRSA) infection. The area under the curves (AUCs) of the receiver operating curves (ROCs) for WBC, NEU, NLR, FIB, ALB and PA were 0.807, 0.811, 0.730, 0.705, 0.663 and 0.796, respectively. The AUCs for other inflammatory indicators were not statistically significant. There was no significant difference in antibiotic resistance for Staphylococcus aureus when compared to that of gram-positive bacteria. The resistance of gram-positive bacteria to ceftriaxone (CRO), cefoxitin (FOX), chloramphenicol (CHL), minocycline (MNO) and tetracycline (TCY) was lower than that of gram-negative bacteria, while the resistance to gentamicin (GEN) was higher. Conclusion: This study demonstrated that WBC, NEU, NLR, FIB and PA have good predictive value for identifying patients at risk of SSI. The cut-off values of inflammatory indicators can be helpful in the prevention and diagnosis of SSI.

Diagnostic value of procalcitonin, hypersensitive C-reactive protein and neutrophil-to-lymphocyte ratio for bloodstream infections in pediatric tumor patients.

OBJECTIVES: Bloodstream infection (BSI) is one of the major causes of death in pediatric tumor patients. Blood samples are relatively easy to obtain and thus provide a ready source of infection-related biological markers for the prompt evaluation of infection risk. METHODS: A total of 259 pediatric tumor patients were included from May 2019 to March 2022. Patients were divided into BSI group (n=70) and control group (n=189). Clinical and biological data were collected using electronic medical records. Differences in biological markers between BSI group and control group and differences before and during infection in BSI group were analyzed. RESULTS: The infected group showed higher levels of procalcitonin (PCT) and hypersensitive C-reactive-protein (hsCRP), and lower prealbumin (PA) than the uninfected group. Area under the receiver-operating curve (ROC) curves (AUC) of PCT, hsCRP and NLR (absolute neutrophil count to the absolute lymphocyte count) were 0.756, 0.617 and 0.612. The AUC of other biomarkers was ≤0.6. In addition, PCT, hsCRP, NLR and fibrinogen (Fg) were significantly increased during infection, while PA and lymphocyte (LYM) were significantly decreased. Antibiotic resistant of Gram-positive bacteria to CHL, SXT, OXA and PEN was lower than that of Coagulase-negative Staphylococcus. Resistant of Gram-positive bacteria to CHL was lower, while to SXT was higher than that of Gram-negative bacteria. CONCLUSIONS: This study explored the utility of biomarkers to assist in diagnosis and found that the PCT had the greatest predictive value for infection in pediatric tumor patients with BSI. Additionally, the PCT, hsCRP, NLR, PA, LYM and Fg were changed by BSI.

An in vitro evaluation of radiation effects of different fractionated regimens by absolute cell count beads.

Recently, whole-body gamma-knife as a kind of radiotherapy equipment, characterized by precision of targeting irradiation, was applied in clinic. However, there is no conventional treatment regimen suitable for application to whole-body gamma-knife as yet. For providing reference to clinic to determine and optimize the treatment regimens for whole-body gamma-knife, a simple and quick bivariate flow cytometric approach was adopted to evaluate the killing effects of differently fractionated regimens of whole-body gamma-knife radiotherapy on the same cells, in which Annexin V-FITC (fluorescein-isothiocyanate) was used for discriminating apoptotic cells, propidium iodide (PI) for necrotic or dead cells and absolute cell count beads for absolute count of remnant surviving cells to examine the absolute killing effect. The results showed that the different survival rates of the same cells treated with different multifractionated irradiation regimens, relevant to clinical trial, might be sensitively, easily and rapidly evaluated by this approach. The evaluation of absolute killing effect, which is important to clinic, is very difficult to realize by a conventional clonogenic assay. For the approach adopted in the experiments, the cells in the treatment courses were not affected by non-treatment factors, such as cell migration, detachment, reattachment, bystander effect and medium factors encountered in a conventional clonogenic assay, and the conditions were more relevantly similar to cells in vivo. This approach might be used as a rapid cell survival assay especially in evaluating the absolute killing effect of a multifractionated treatment regimen, and also applied in the assessment in cytotoxic killing effect, such as chemotherapy.