Abstract
Procalcitonin (PCT) and Interleukin-6 (IL-6) have emerged as biomarkers for different inflammatory conditions. The purpose of the study was to evaluate the role of PCT and IL-6 as biomarkers of cancer and its progression in a large cohort of patients. This cross-sectional study included residual plasma samples collected from cancer patients, and control subjects without cancer. Levels of PCT and IL-6 were determined by Kryptor compact bioanalyzer. We identified 575 febrile cancer patients, 410 non-febrile cancer patients, and 79 non-cancer individuals. The median PCT level was lower in control subjects (0.029 ng/ml) compared to cancer patients with stage I-III disease (0.127 ng/ml) (p<0.0001) and stage IV disease (0.190 ng/ml) (p<0.0001). It was also higher in febrile cancer patients (0.310 ng/ml) compared to non-febrile cancer patients (0.1 ng/ml) (p<0.0001). Median IL-6 level was significantly lower in the control group (0 pg/ml) than in non-febrile cancer patients with stages I-III (7.376 pg/ml) or stage IV (9.635 pg/ml) (p<0.0001). Our results suggest a potential role for PCT and IL-6 in predicting cancer in non-febrile patients. In addition, PCT is useful in detecting progression of cancer and predicting bacteremia or sepsis in febrile cancer patients.
Highlights
Procalcitonin (PCT) is the prohormone of calcitonin and thought to be mainly produced in the liver by macrophages (Kupffer cells) or neuroendocrine cells [1,2,3]
We found that PCT and IL-6 could have a role in predicting cancer as our findings showed that PCT and IL-6 levels were higher in cancer patients than normal subjects
Our findings of higher PCT levels in certain malignancies such as: colon cancer, leukemia, thyroid cancer, lymphoma, and prostate cancer agree with previous reports of increased serum PCT in tumors such as small cell lung cancer, carcinoid, pheochromocytoma, pancreatic islet, breast, thyroid, lung, gastro-intestinal including colon cancer and urogenital tumors [8, 9, 19, 20]
Summary
Procalcitonin (PCT) is the prohormone of calcitonin and thought to be mainly produced in the liver by macrophages (Kupffer cells) or neuroendocrine cells [1,2,3]. Over the last two decades several studies have demonstrated that PCT is highly associated with bacterial infections, bacteremia [4,5,6]. PCT has been suggested as a potential biomarker for sepsis and infection and as a guide to antibiotic administration [5, 7]. Neuroendocrine tumors may exhibit high levels of serum PCT and an association has been determined between PCT levels and the clinical course of these tumors [8]. Matzaraki et al reported increased serum PCT levels in cancer patients with metastatic disease [9].
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