Clinical Significance Of Procalcitonin Research Articles

The Elevation in Preoperative Procalcitonin Is Associated with a Poor Prognosis for Patients Undergoing Resection for Colorectal Cancer

Background: Procalcitonin (PCT) is a well-known marker for bacterial infection; however, the clinical significance of PCT in the long-term prognosis after colorectal cancer (CRC) surgery remains unclear. Methods: This is a retrospective review of 277 patients that underwent CRC surgery to investigate the relationship between preoperative PCT, clinicopathological condition, cancer-specific overall survival (OS), and relapse-free survival (RFS). Results: Median follow-up interval was 5.0 years in all patients. Thirty-six patients developed recurrence, and 46 patients died due to recurrences or metastases of CRC. Preoperative PCT levels were highest in Stage IV patients. The cancer-specific OS in patients with Stage IV/PCT ≤0.05 ng/mL was significantly higher than those with Stage IV/PCT >0.05 ng/mL (3 years survival; 42.3 vs. 14.3%, p = 0.0413). On multivariate analysis, gender, TNM classification, and PCT were identified as significant risk factors for cancer-specific OS in patients with Stage I–III CRC. The cancer-specific OS rate of these patients with PCT ≥0.08 ng/mL, compared with PCT <0.08 ng/mL, was significantly decreased (5 years survival; 59.1 vs. 92.7%, p < 0.0001). TNM classification was finally identified as an independent risk factor for cancer-specific RFS in these patients by multivariate analysis. Conclusion: High preoperative PCT values in CRC patients appeared to be associated with poor OS but not RFS following surgical treatments.

Clinical significance of procalcitonin in early diagnosis of acute left heart failure complicated with pulmonary infection in the elderly

Objective To investigate clinical significance of procalcitonin(PCT)in the early diagnosis of acute left heart failure complicated with pulmonary infection in the elderly. Methods A total of 113 patients with acute left heart failure or acute left heart failure complicated with pulmonary infection who were admitted into our emergency department from August 2012 to February 2018 were retrospectively analyzed.Data of serum concentration of PCT were collected on the first and third days after admission.The diagnostic values of serum PCT and C-reaction protein(CRP)were evaluated based on the patient's diagnostic data.ROC curves were plotted for PCT, and its cut-off value was calculated. Results Serum levels of PCT on the first and third days after admission were higher in pulmonary infection group than in left heart failure group[(2.45±0.42) μg/L vs.(0.54±0.03) μg/L, (1.25±0.17) μg/L vs.(0.43±0.03) μg/L, t=34.27 and 35.78, P=0.000 and 0.000]. The diagnostic specificity, positive predictive value, and negative predictive value of PCT were better than those of CRP(χ2=4.97, 4.76 and 4.17, P=0.030, 0.030 and 0.040). There was no significant difference in the diagnostic sensitivity between PCT and CRP(χ2=3.05, P=0.080). The best diagnostic cut-off value of PCT was 0.597 μg/L in which the sensitivity of diagnosis of heart failure complicated with pneumonia was 91.07% and the specificity was 90.77%. Conclusions Serum PCT test can assist the early diagnosis of acute left heart failure complicated with pulmonary infection in elderly patients with high sensitivity and specificity.The best diagnostic cut-off value of PCT is 0.597 μg/L.Based on serum PCT test, early rational use of antibiotics for controlling acute left heart failure complicated with pulmonary infection in elderly patients is worthy of generalization. Key words: Calcitonin; Heart failure; Early diagnosis; Pneumonia

Changes and clinical significance of procalcitonin and hypersensitive C reactive protein levels after acute appendicitis surgery

目的 探讨急性阑尾炎术后降钙素原(PCT)、超敏C反应蛋白(hs-CRP)的变化及其与抗生素应用的关系。 方法 分析急性阑尾炎行阑尾切除术的患者85例的临床资料，观察不同类型急性阑尾炎术后1 d、3 d、5 d血清PCT、hs-CRP的变化；40例在血清PCT恢复正常(<0.5 ng/mL)后停止使用抗生素(观察组)，45例按hs-CRP和中性粒细胞百分比(NP)指标停用抗生素(对照组)，比较两组抗生素使用时间、感染相关并发症(脓毒血症、腹腔感染及切口感染等继发感染)以及患者住院时间的差异。 结果 急性阑尾炎患者术后1 d血清PCT、hs-CRP升高，术后3 d开始下降。观察组术后住院时间、感染相关并发症发生率、抗生素使用时间分别为(4.0±2.5)d、0.0%、(3.1±1.5)d，对照组分别为(5.5±1.5)d、2.2%、(4.5±2.1)d，两组感染相关并发症发生率差异无统计学意义(P>0.05)，两组住院时间、抗生素使用时间差异均有统计学意义(t＝3.978、3.563，均P<0.05)。 结论 血清PCT对于急性阑尾炎术后抗生素应用具有较好的临床指导价值。

Clinical significance of procalcitonin combined with hypersensitive c-reactive protein detection in senile pneumonia

Objective To discuss the clinical significance of procalcitonin (PCT) combined with hypersensitive c-reactive protein (hs-CRP) in the diagnosis of senile pneumonia.Methods 30 cases of senile pneumonia patients who received and goy cured in our hospital from March 2009 to March 2013 were selected as observation group,30 cases of healthy medical examiner in the corresponding period were chosen as control group,then we compared PCT,hs-CRP concentration differences of the two groups by using solid-phase sandwich method enzyme-linked immunosorbent (ELISA),and took linear correlation analysis of the two indexes (PCT,hs-CRP).Results (1) The PCT level of the observation group was (1.12 ± 0.26) μ g/L,and the hs-CRP level was (4.79 ± 0.23) mg/L,in the control group,the PCT and hs-CRP were (0.25 ± 0.09) μ g/L and (1.44 ± 0.06)mg/L respectively,the two groups had statistically significant differences by comparison (P ＜ 0.01),the observation group was significantly higher than that of the control group; (2) serum PCT and hs-CRP levels were positively correlated in the observation group (r=0.759,P ＜ 0.05).Conclusion Procalcitonin combined with hypersensitive c-reactive protein had higher application value in the diagnosis of senile pneumonia and the assessment of prognosis. Key words: Senile pneumonia; Procalcitonin; Hypersensitive c-reactive protein

The clinical significance of procalcitonin to identifying microorganism strains in ICU patients with bloodstream infection

Objective To investigate the level of serum procalcitonin (PCT) for exploring the clinical value in identifying microorganism strains in the intensive care unit (ICU) patients with blood stream infections.Methods A retrospective analysis of patients with positive blood culture of a single strain and with serum PCT levels detected simultaneously was carried out from January 2010 through December 2012.The comparisons of PCT levels were done among Gram-negative (G-) bacteria,Gram-positive (G +) bacteria and fungi in patients with bloodstream infections.The diagnostic performance of PCT was determined by the receiver operating characteristic curve (ROC).Results A total of 524 patients with blood stream infection were enrolled and categorized into three different groups,namely G-bacteria infection group (n =206),G + bacteria infection group (n =276),and fungi infection group (n =42).The median value of PCT level of G-bacteria group was 14.9 ng/ml,which was significantly higher than that of the other two groups with 0.14 ng/ml and 1.76 ng/ml,respectively (P ＜ 0.01).Further,the PCT level of fungi group also obviously higher than that of G + bacteria group (P ＜ 0.001).According to ROC,PCT level at 2.11 ng/ml could distinguish G-bacteria infection from G + bacteria infection with sensitivity 82.8％ and specificity 80.1％,while PCT at 5.09 ng/ml was used to distinguish G-bacteria infection from fungi infection with sensitivity 68％ and specificity 73.8％.The area under the ROC of G + bacteria and fungi was 33.0％ (P ＜ O.01).Conclusions Serum PCT level is valid for distinguishing ICU patients with blood stream infection caused by G-bacteria from G+ bacteria or from fungi,but the validity of PCT for distinguishing G + bacteria from fungi infection needs to be set up by further studies. Key words: Procalcitonin; ICU ; Bloodstream infection ; Microorganism types

The clinical significance of procalcitonin in patients with intracranial infection

Objective To investigate the values and clinical significance of procalcitonin(PCT)determination in the diagnosis of intracranial infection.Methods 62 patients with acute meningitis were divided into bacterial meningitis group and viral meningitis group according to the type of infection.Serum PCT levels were detected at different stages of meningitis and cerebrospinal fluid was analyzed.Results PCT levels were(26.43±15.32)μg/L in the acute phase of bacterial meningitis and significantly higher than the normal level;after treatment,they were(5.85±5.43)/ag/L on day 3,(0.21±0.26)μg/L on day 5,and(0.06±0.12)μg/L on day 7,being significantly reduced(P<0.05).PCT levels were(1.64±3.25)μg/L in the acute phase and(0.83±3.12)μg/L on day 3 in viral encephalitis group,which were significantly lower than those in bacterial meningitis group(P<0.05).CRP levels did not differ significantly between the two groups[(28.3±15.3)(5-110)mg/L vs.(27.3±16.4)(0-45)mg/L,P＞0.05].There were significant differences between the two groups in leukocyte count and protein level in CSF[(287±15)(24-590)×lO6 vs.(17±5)(6-120)×l06 and(1.68±0.36)(0.4-4.8)mg/L vs.(0.67±0.32)(O.1-2.5)mg/L,P<0.05],but there was a overlap in the two groups.Conclusions Serum procalcitonin determination has important clinical significance in the early differential diagnosis of bacterial meningitis with viral encephalitis. Key words: Procalcitonin; Intracranial infection; Clinical significance