Value Of Serum Procalcitonin Level In Differentiation Between Infections And Tumor-related Fever In Patients With Malignant Tumors

ObjectiveTo assess the value of serum procalcitonin(PCT)level in the differentiation between infections and tumor-related fever in patients with malignant tumors.MethodsPatients were studied in a retrospective case control method.Serum levels of PCT and related indicators were studied in 139 patients(173 cases)with malignant tumors admitted in the Hospital 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 was assessed by receiver operating characteristic(ROC).The changes of PCT before and after antibiotic treatment were compared.ResultsThere were significant differences in serum PCT levels among patients with different types of tumors(?~2=11.238,P=0.047)and between patients with metastases and without metastases(Z=-2.663,P=0.008)in infected patients,as well as in non-infected patients(?~2=12.374,Z=-2.519,P=0.015,0.012;respectively).The PCT levels of infection with fever group,infection without fever group,tumor-related fever group and non-infection,non-fever group were 0.449ng/ml(0.148,2.090),0.107ng/ml(0.056,0.441),0.254ng/ml(0.100,0.530)and 0.058ng/ml(0.043,0.124),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-of value for PCT was defined at 0.955ng/ml,the sensitivity and specificity of PCT in differentiation between infection and tumor-related fever was 0.34 and 0.94,respectively.PCT level of the tumor-related fever group did not change significantly before and after antibiotic treatment.ConclusionTumor types and metastasis factors can affect serum PCT level,and PCT level can be increased in tumor-related fever,which could affect value of PCT in diagnosis of infection in tumor patients.Comparison of changes in PCT levels may help to distinguish infectious fever from tumor-related fever.