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, ) as well as change in FeNO (median: 10.0 vs. 0.0 ppb, ) 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, ), POD1 FeNO (OR = 1.048, 95% CI: 1.019–1.077, ), and change in FeNO (OR = 1.087, 95% CI: 1.044–1.132, ) 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.

中文翻译：

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围手术期呼出的一氧化氮作为手术肺癌患者术后肺炎的指标：基于 183 例病例的前瞻性队列研究

简介。本研究旨在探讨围手术期呼出气一氧化氮分数与术后肺炎（POP）的相关性，以及围手术期 FeNO 预测手术肺癌患者 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，根据患者基本特征和院内临床资料评价围手术期 FeNO 与 POP 的关系。结果。共有 218 名患者参加了这项研究。最终，183 名患者参与了研究，其中 POP 组 19 人，非 POP 组 164 人。POP 组术后 FeNO 显着升高（中位数：30.0 对 19.0 ppb，)以及 FeNO 的变化（中位数：10.0 对 0.0 ppb，)手术前后。对于基于接受者操作特征 (ROC) 曲线预测 POP，术后 FeNO 的截止值为 25 ppb（约登指数：0.515，敏感性：78.9%，特异性：72.6%）和 FeNO 变化的截止值为 4 ppb（约登指数: 0.610, 敏感性: 84.2%, 特异性: 76.8%) 被选中。此外，根据双变量回归分析，FEV1/FVC (OR = 0.948, 95% CI: 0.899–0.999,), POD1 FeNO (OR = 1.048, 95% CI: 1.019–1.077,)，以及 FeNO 的变化 (OR = 1.087, 95% CI: 1.044–1.132,)与 POP 的发生显着相关。结论。这项前瞻性研究表明，较高的术后 FeNO (>25 ppb) 以及 FeNO 变化增加 (>4 ppb) 可能具有检测手术肺癌患者 POP 发生的潜力。