Value of serum procalcitonin level in differentiation between infections and tumor-related fever in patients with malignant tumors

Abstract

Objective To assess the value of serum procalcitonin (PCT) level in the differentiation between infections and tumor-related fever in patients with malignant tumors. Methods Serum levels of PCT and related indicators were measured in 139 patients (173 times) with malignant tumors admitted in the First Affiliated Hospital of Anhui Medical University from December 2014 to December 2015. There were 64 cases of infection with fever, 44 cases of infection without fever, 36 cases of tumor-related fever and 29 non-infection, non-fever cases. Serum PCT levels of patients in 4 groups were compared by non-parametric test, and the value of PCT in the differentiation of infections and tumor-related fever was assessed by receiver operating characteristic (ROC) curve. Results There were significant differences in serum PCT levels among patients with different type of tumors (χ2=11.238, P=0.047) and between patients with metastases and without metastases (χ2=12.658, P=0.005) in infected patients, as well as in non-infected patients (χ2=12.374, 9.942, P=0.015, 0.019; respectively). The PCT levels of infection with fever group, infection without fever group, tumor-related fever group and non-infection, non-fever group were 0.449(0.148, 2.090)μg/L, 0.107(0.056, 0.441)μg/L, 0.254(0.100, 0.530)μg/L and 0.058(0.043, 0.124)μg/L, respectively. There was no significant difference in PCT levels between tumor-related fever group and infection without fever group(Z=-1.480, P=0.139), between tumor-related fever group and blood culture negative infection with fever group (Z=-0.965, P=0.334). According to the ROC, the cut-off value for PCT was defined at 0.955 μg/L, the sensitivity and specificity of PCT in differentiation between infection and tumor-related fever was 0.34 and 0.94, respectively. Conclusion Tumor types and metastasis can affect serum PCT level, and PCT level can be increased in tumor-related fever, which would affect value of PCT in diagnosis of infection in tumor patients. Key words: Neoplasms; Infection; Procalcitonin; Tumor-related fever