Diagnostic Value of Heparin‐Binding Protein (HBP) in Pulmonary Infection After Radical Surgery for Lung Cancer: A Retrospective Study

ABSTRACT Background and Aims Heparin‐binding protein (HBP) has the potential clinical utility in the early diagnosis and prognosis evaluation of infectious diseases. We aimed to assess the early diagnostic value of HBP in combination with other biomarkers for detecting pulmonary infection post‐surgery. Methods We retrospectively included patients who underwent radical lung cancer surgery at the Shanghai Chest Hospital between January 2023 and August 2023. The least absolute shrinkage and selection operator (LASSO) and binary logistic regression analyses were conducted to identify independent predictors for pulmonary infection after surgery. The diagnostic performance of HBP and other biomarkers was assessed using the receiver operating characteristic (ROC) curves. Results Among 292 patients, 31 (10.6%) developed pulmonary infection post‐surgery, while 261 (89.4%) did not. The levels of HBP, white blood cell (WBC), neutrophil, neutrophil‐to‐lymphocyte ratio (NLR), C‐reactive protein (CRP), interleukin‐6 (IL‐6), and interleukin‐8 (IL‐8) were significantly higher in the pulmonary infection group compared to the control group (p < 0.001). Regression analyses identified HBP, NLR, and CRP as independent predictors for pulmonary infection post‐surgery (ORs with 95%CI: 1.041, 1.024–1.059; 1.132, 1.074–1.193; and 1.05, 1.028–1.073, respectively). The ROC analysis determined that a HBP level ≥ 52.36 ng/mL yielded a sensitivity of 71%, a specificity of 77.4%, and an area under the curve (AUC) of 0.78 for predicting pulmonary infection. The AUCs of NLR, CRP, IL‐6, and IL‐8 were 0.74, 0.72, 0.67, and 0.72, with corresponding specificities of 76.5%, 73.5%, 71.2%, and 66.5%, and sensitivities of 64.5%, 67.7%, 67.7%, and 71.0%, respectively. The combination of HBP, NLR, and CRP showed superior diagnostic performance with the highest AUC of 0.92. Conclusion HBP is an independent predictor of pulmonary infection following radical lung cancer surgery. Combined monitoring of HBP, NLR, and CRP can aid in the early diagnosis of postoperative pulmonary infections, supporting clinical assessment and timely intervention.