Serum procalcitonin and C-reactive protein detection in diagnosis of fever in hematological maliganancies

Abstract

Objective To explore the diagnosis significance of serum procalcitonin (PCT) and C-reactive protein(CRP) in the fever of hematological maliganancies. Methods The levels of serum PCT and CRP in 186 fever patients with hematological maliganancies and 30 non-fever patients with hematological maliganancies were analyzed retrospectively. According to the clinical characteristics, the patients were divided into infectious fever patients (165 cases), non-infectious fever patients (21 cases) and non-fever patients (30 cases). The infectious fever patients were divided into the bacterial infection (102 cases), the fungal infection (27 cases), and the virus infection (36 cases). The patients confirmed with bacteria infection were divided into blood culture positive patients (24 cases, including 12 cases of gram-negative bacteria infection and 12 cases of gram-positive bacteria infection) and blood culture negative patients (78 cases) according to the result of blood culture. The levels of serum PCT and CRP were compared. Results The levels of serum PCT and CRP in infectious fever patients were higher than those in non-infectious fever patients and non-fever patients:1.40(0.02-54.81) μg/L vs. 0.45(0.04-12.80) μg/L and 0.30(0.01-0.98) μg/L, 78.9(3.6-199.6) mg/L vs. 17.1(2.4-78.9) mg/L and 6.7(1.0-24.2) mg/L,and there were significant differences (P 0.05). The level of serum PCT in bacterial infection was higher than that in fungal infection and virus infection:1.60 (0.28-54.81) μg/L vs. 0.55 (0.17-9.60) μg/L and 0.38 (0.02-12.45) μg/L, and there was significant difference (P 0.05). There was no significant difference in the level of serum CRP among bacterial infection, fungal infection and virus infection (P >0.05). The level of serum PCT and the positive rate of PCT in blood culture positive patients were higher than those in blood culture negative patients: 2.10 (0.35-54.81) μg/L vs. 0.78(0.28-22.41) μg/L, 87.5% (21/24) vs. 66.7% (52/78), there were significant differences (P 0.05). There were no significant differences in the level of serum CRP and the positive rate of CRP between blood culture positive patients and blood culture negative patients, or between gram-negative bacteria infection and gram-positive bacteria infection (P >0.05). Conclusions Serum PCT concentration can help to distinguish the infectious fever and non-infectious fever, especially to gram-negative bacteria infection. Serum CRP concentration is significant in distinguishing the infectious fever and non-infectious fever. Key words: Hematologic neoplasms; Fever; C-reactive protein; Procalcitonin