Diagnostic value of immune indicators and cytokines in sepsis after percutaneous nephrolithotomy (PCNL)

To analyse the changes in and diagnostic value of immune indicators and cytokines in patients with sepsis after percutaneous nephrolithotomy (PCNL).

Clinical information was gathered from 405 patients with calculi who underwent PCNL at our facility between January 2021 and December 2024. The patients were divided into a sepsis group (12 patients) and a non-sepsis group (393 patients) based on whether sepsis occurred after the operation. The levels of CD4+/CD 8 + cells, the neutrophil-to-lymphocyte ratio (NLR), soluble trigger receptor-1 (sTREM-1) in myeloid cells, procalcitonin (PCT), tumour necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) were measured in the two patient groups. The predictive value of the above indicators for sepsis was analysed via receiver operating characteristic (ROC) curves.

The number of patients with staghorn calculi in the sepsis group was greater than that in the nonsepsis group (P< 0.05). The NLR and sTREM-1 levels were greater in the sepsis group than in the nonsepsis group (all P< 0.05), and the CD 4+/CD 8+ ratio was lower in the sepsis group than in the nonsepsis group (P< 0.05). The levels of serum IL-6, TNF-α and PCT in the sepsis group were greater than those in the nonsepsis group (all P< 0.05). The area under the curve (AUC) for the combined prediction of sepsis after PCNL by each index was 0.996, with a predictive sensitivity of 91.3% and a specificity of 98.4%.

The NLR, sTREM-1, IL-6, TNF-α and PCT in patients with sepsis after PCNL increased, whereas the CD 4+/CD 8+ ratio decreased. The combined detection of these levels is beneficial for guiding the early clinical prediction of postoperative sepsis in patients undergoing PCNL.