Gui-Xian Liu, Yue Yang, Lei Chen, Mi-Qi Gu, Jin-Tao He, Xin Wang
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The POP group had significantly higher postoperative FeNO (median: 30.0 vs. 19.0 ppb, <i>P</i> < 0.001) as well as change in FeNO (median: 10.0 vs. 0.0 ppb, <i>P</i> < 0.001) before and after the surgery. For predicting POP based on the receiver operating characteristic (ROC) curve, a cutoff value of 25 ppb for postoperative FeNO (Youden's index: 0.515, sensitivity: 78.9%, and specificity: 72.6%) and 4 ppb for change in FeNO (Youden's index: 0.610, sensitivity: 84.2%, specificity: 76.8%) were selected. Furthermore, according to the bivariate regression analysis, FEV1/FVC (OR = 0.948, 95% CI: 0.899-0.999, <i>P</i>=0.048), POD1 FeNO (OR = 1.048, 95% CI: 1.019-1.077, <i>P</i>=0.001), and change in FeNO (OR = 1.087, 95% CI: 1.044-1.132, <i>P</i> < 0.001) were significantly associated with occurrence of POP.</p><p><strong>Conclusions: </strong>This prospective study revealed that a high postoperative FeNO (>25 ppb), as well as an increased change in FeNO (>4 ppb), may have the potential in detecting the occurrence of POP in surgical lung cancer patients.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9464969/pdf/","citationCount":"0","resultStr":"{\"title\":\"Perioperative Exhaled Nitric Oxide as an Indicator for Postoperative Pneumonia in Surgical Lung Cancer Patients: A Prospective Cohort Study Based on 183 Cases.\",\"authors\":\"Gui-Xian Liu, Yue Yang, Lei Chen, Mi-Qi Gu, Jin-Tao He, Xin Wang\",\"doi\":\"10.1155/2022/9149385\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>This study is conducted to investigate the correlation between perioperative fractional exhaled nitric oxide and postoperative pneumonia (POP) and the feasibility of perioperative FeNO for predicting POP in surgical lung cancer patients.</p><p><strong>Methods: </strong>Patients who were diagnosed with non-small-cell lung cancer (NSCLC) were prospectively analyzed, and the relationship between perioperative FeNO and POP was evaluated based on patients' basic characteristics and clinical data in the hospital.</p><p><strong>Results: </strong>There were 218 patients enrolled in this study. Finally, 183 patients were involved in the study, with 19 of them in the POP group and 164 in the non-POP group. The POP group had significantly higher postoperative FeNO (median: 30.0 vs. 19.0 ppb, <i>P</i> < 0.001) as well as change in FeNO (median: 10.0 vs. 0.0 ppb, <i>P</i> < 0.001) before and after the surgery. For predicting POP based on the receiver operating characteristic (ROC) curve, a cutoff value of 25 ppb for postoperative FeNO (Youden's index: 0.515, sensitivity: 78.9%, and specificity: 72.6%) and 4 ppb for change in FeNO (Youden's index: 0.610, sensitivity: 84.2%, specificity: 76.8%) were selected. 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引用次数: 0
摘要
前言:本研究旨在探讨围术期呼气一氧化氮分数与术后肺炎(POP)的相关性，以及围术期一氧化氮分数预测外科肺癌患者POP的可行性。方法:对确诊为非小细胞肺癌(NSCLC)的患者进行前瞻性分析，结合患者基本特征及住院临床资料，评价围手术期FeNO与POP的关系。结果:218例患者入组。最终，183例患者参与研究，其中19例为POP组，164例为非POP组。POP组术后FeNO(中位数:30.0 vs. 19.0 ppb, P < 0.001)以及术前和术后FeNO的变化(中位数:10.0 vs. 0.0 ppb, P < 0.001)均显著升高。根据受试者工作特征(ROC)曲线预测POP，术后FeNO(约登指数:0.515，敏感性:78.9%，特异性:72.6%)的临界值为25 ppb, FeNO变化(约登指数:0.610，敏感性:84.2%，特异性:76.8%)的临界值为4 ppb。此外，根据双变量回归分析，FEV1/FVC (OR = 0.948, 95% CI: 0.899-0.999, P=0.048)、POD1 FeNO (OR = 1.048, 95% CI: 1.019-1.077, P=0.001)和FeNO变化(OR = 1.087, 95% CI: 1.044-1.132, P < 0.001)与POP的发生显著相关。结论:本前瞻性研究显示，术后高FeNO (>25 ppb)和FeNO变化增加(>4 ppb)可能具有检测外科肺癌患者POP发生的潜力。
Perioperative Exhaled Nitric Oxide as an Indicator for Postoperative Pneumonia in Surgical Lung Cancer Patients: A Prospective Cohort Study Based on 183 Cases.
Introduction: This study is conducted to investigate the correlation between perioperative fractional exhaled nitric oxide and postoperative pneumonia (POP) and the feasibility of perioperative FeNO for predicting POP in surgical lung cancer patients.
Methods: Patients who were diagnosed with non-small-cell lung cancer (NSCLC) were prospectively analyzed, and the relationship between perioperative FeNO and POP was evaluated based on patients' basic characteristics and clinical data in the hospital.
Results: There were 218 patients enrolled in this study. Finally, 183 patients were involved in the study, with 19 of them in the POP group and 164 in the non-POP group. The POP group had significantly higher postoperative FeNO (median: 30.0 vs. 19.0 ppb, P < 0.001) as well as change in FeNO (median: 10.0 vs. 0.0 ppb, P < 0.001) before and after the surgery. For predicting POP based on the receiver operating characteristic (ROC) curve, a cutoff value of 25 ppb for postoperative FeNO (Youden's index: 0.515, sensitivity: 78.9%, and specificity: 72.6%) and 4 ppb for change in FeNO (Youden's index: 0.610, sensitivity: 84.2%, specificity: 76.8%) were selected. Furthermore, according to the bivariate regression analysis, FEV1/FVC (OR = 0.948, 95% CI: 0.899-0.999, P=0.048), POD1 FeNO (OR = 1.048, 95% CI: 1.019-1.077, P=0.001), and change in FeNO (OR = 1.087, 95% CI: 1.044-1.132, P < 0.001) were significantly associated with occurrence of POP.
Conclusions: This prospective study revealed that a high postoperative FeNO (>25 ppb), as well as an increased change in FeNO (>4 ppb), may have the potential in detecting the occurrence of POP in surgical lung cancer patients.
期刊介绍：
Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.
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