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Objective   To explore the relationship and diagnostic value of serum MMP-9 and SAA in severe pneumonia (sCAP) caused by radiotherapy of esophageal cancer.Methods   A total of 144 esophageal cancer patients who underwent radiotherapy in our hospital from April 2016 to February 2018 were collected. Among them, 58 patients without radiation pneumonitis (RP) were in the control group, 49 patients with grade 1∼2 RP were in the radiation group, and 37 patients with sCAP were in the severe group. The levels of serum MMP-9 and SAA in every group of patients were detected. The ROC curve was used to determine the diagnostic value of serum MMP-9 and SAA in the diagnosis of RP and sCAP. The correlation between serum MMP-9 and SAA and the patient's lung function indexes was analyzed, and the logistic single-factor and multivariate analyses were performed to analyze the factors of sCAP in esophageal cancer radiotherapy.Results   PaO 2 , FVC, and FEV1 decreased in RP and sCAP, and PaCO 2 , white blood cells, serum MMP-9, and SAA levels increased ( P  < 0.05); serum MMP-9 and SAA were negatively correlated with lung function ( P  < 0.05); the AUC of serum MMP-9 and SAA in RP was 0.833 and 0.823, respectively, and the AUC of the two combined diagnosis of RP was 0.919. The AUC of serum MMP-9 and SAA in sCAP was 0.809 and 0.797, respectively, and the AUC of both combined diagnosis of sCAP was 0.873; logistics multivariate analysis found that serum MMP-9, serum SAA, double lung V5, and V20 were independent risk factors for sCAP caused by radiotherapy for esophageal cancer ( P  < 0.05).Conclusion   Serum MMP-9 and SAA increase in RP and sCAP and are negatively correlated with lung function in patients with pneumonia. They are independent risk factors for severe pneumonia caused by radiotherapy of esophageal cancer and have good diagnostic value.

Serum MMP-9 and SAA in the Diagnosis of Severe Pneumonia Caused by Radiotherapy of Esophageal Cancer