ДИАГНОСТИЧЕСКИЙ ПОТЕНЦИАЛ С-РЕАКТИВНОГО БЕЛКА ПРИ СЕПСИСЕ У ОНКОГЕМАТОЛОГИЧЕСКИХ БОЛЬНЫХ

Abstract

The study aims to analyze the dynamics, diagnostic, and prognostic significance of C-reactive protein (CRP) in sepsis in oncohematological patients. The CRP levels were compared in 30 patients with lymphoproliferative diseases using two designs. The first design included patients who received cytostatic therapy (groups 1 and 3 with and without complications, respectively), as well as patients who received autologous hematopoietic stem cell transplantation after cytostatic therapy (groups 2 and 4 with and without complications, respectively). The second design consisted of two groups of patients: the first with sepsis (n = 15) and the second without any complications (n = 15). In statistical analysis, the Mann–Whitney U test or Student’s t-test (at p < 0.05) were used to compare quantitative indicators according to the distribution type, and the ROC curve (AUC) was used to assess the diagnostic significance of CRP in predicting a specific outcome. Statistically significant differences were found in the level of CRP in both groups with sepsis compared to the corresponding groups without sepsis (p1–3 < 0.001, p2–4 < 0.001), the level of CRP depending on the outcome (recovery/death) in both study designs (p < 0.05), and the dynamics of CRP when comparing groups with sepsis. When assessing the diagnostic significance of CRP, AUC = 0.862 ± 0.029 with 95 % CI: 0.806–0.918, sensitivity (Se) was 85.7 % and specificity (Sp) was 69.7 %. When predicting 10-day mortality, AUC = 0.756 ± 0.069 with 95 % CI: 0.621–0.892, Se was 57.9 % and Sp was 89.2 %, the model was statistically significant (p < 0.001) in both cases. As an available marker, CRP has good diagnostic value in the comprehensive sepsis diagnosis, in particular in hematological oncology patients.