The Clinical Significance Of PCT And Hs-CRP In Early Bacterial Infection After Chemotherapy In Patients With Hematological Malignancies By ROC Curve

BackgroundBacterial infection in patients with hematological malignancies after chemical treatment has high incidence,which is an important factor affecting the mortality rate of patients with hematological diseases and is common for emergency and severe cases.So the rapid diagnosis is critical.The clinical diagnosis of infection mainly depends on the experience of clinicians,who basised on peripheral blood leukocyte count,neutrophil absolute value to determine.But the white blood cell and neutrophil after chemotherapy in patients with hematological malignancies are reduced,which don't really response to bacteria and toxins,and traditional blood culture positive rate is low,which is helpless in the diagnosis.So it is urgent to find a fast and reliable indicator of early diagnosis laboratory to assist in the treatment of malignant hematological disease after chemical bacterial infection.ObjectiveTo investigate the significance in medicine of the detection of alone hs-CRP,alone PCT and PCT binded hs-CRP for early bacterial infection diagnosis after chemotherapy of malignant blood disease patients.MethodsThe areas?specificity?sensitivity of high sensitive C protein,procalcitonin and PCT binded hs-CRP,were analyzed through the application of ROC curve.The best threshold value of PCT,hs-CRP were analyzed.PPV,negative predictive value of PCT,hs-CRP and both of their binded were compared and analyzed,accuracy was too compared and analyzed.ResultsThrough ROC curve,the area of PCT was 0.845(95%CI0.779-0.911).hs-CRP was0.719(95%CI0.639-0.798).PCT combined with hs-CRP was 0.819(95%CI0.748-0.890).The best threshold value of PCT,hs-CRP was 0.955ng/ml?23.4mg/L respectively.The sensitivity of procalcitonin was 90.0% and specificity was 67.6%;Hs-CRP was respectively 70.7% ? 57.2%;The sensitivity value of hs-CRP and specificity value of hs-CRP were lower than that of PCT.The sensitivity value of PCT binded hs-CRP was63.8% and specificity value was 86.4%.The PPV of PCT,hs-CRP and PCT binded hs-CRP were 90.7%,85.2%,94.3%;The NPV were 65.8%,35.6%,40.5%;The accuracy were 85.0%,64.7%,68.9%.Conclusion1.PCT for clinical bacterial infection diagnosis in patients with hematological malignancies after chemical treatment,the optimal threshold is 0.955 ng/ml,hs-CRP is23.4mg/L.2.The specificity,sensitivity,PPV,NPV,accuracy of PCT were high,which could be used as a reliable index for early clinical bacterial infection diagnosis of hematological malignancies after chemotherapy.3.The specificity of PCT binded hs-CRP simultaneous detection is more beneficial to the early clinical bacterial infection diagnosis of malignant hematological diseases after chemotherapy.