| Objective: To explore and verify the feasibility of PCT as a biomarker for patients with malignant tumors,and to provide evidence for the application of PCT to guide anti-infective treatment of cancer patients.Methods: The age,sex,histological type,TNM staging and functional score(ZPS score)of 365 malignant tumor patients who met the inclusion criteria were collected from a ward of the Fourth Hospital of Chinese Medical University.And collect infection-related symptoms,signs,laboratory tests and imaging examinations,and diagnosis and treatment.Focus on comparing the statistical difference between blood PCT,WBC count and CRP value between infected group and non-infected group,calculate ROC curve,cut-off point,area under curve(AUC),sensitivity and specificity;compare transfer factors and other factors to PCT influential.Result: There were 365 tumor patients enrolled.The number of patients in stage I,II,III,and IV was 25(6.8%),31(8.5%),31(8.5%),and 212(58.1%).Most patients with stage IV.The top five tumors in histological classification include lung cancer,colorectal cancer,genitourinary tumors,breast cancer,and gastric cancer(tied),with the largest number of lung cancer patients.The number of non-infected and infected patients was212(58.1%)and 153(41.9%),respectively.The infected group included bloodstream infection and local infection.The PCT value,CRP value and WBC count of the bloodstream infection group were 6.70 ng/mL,146.00 mg/dL and 15.46×10^9/L,respectively.The PCT value,CRP value and WBC count of the local infection group were 0.14 ng/ mL,37.45 mg/dL and 8.82×10^9/L?The PCT value,CRP value and WBC count in the non-infected group were 0.04 ng/mL,4.79 mg/dL and 5.96×10^9/L,respectively.The values of PCT,CRP and WBC in the infected group were higher than those in the non-infected group(P<0.001).The PCT value of the patients with bloodstream infection was higher than that of the local infection group.The difference was statistically significant(P<0.001).By the absolute value of PCT,it can be concluded that 5 of 7 patients with bloodstream infection have PCT values above 2.0 ng/mL,accounting for 71.4% of patients with bloodstream infections;and among 146 patientswith local infection,PCT There were 127 patients with a value between 0.05 and 2.0ng/mL,accounting for 73.3% of all patients with local infection.Of the 212 patients in the uninfected group,125 had PCT values below 0.05 ng/mL,accounting for 59.0%of all non-infected patients.The ROC curve was drawn to obtain a cut-off point of PCT value for diagnosis of infection of 0.066 ng/mL,AUC of 0.808,sensitivity and specificity of 76.5% and 69.8%,respectively.The cut-off point of WBC count diagnosis infection was 8.52×10^9/ l,AUC is 0.739,sensitivity and specificity are 54.9% and 91%,respectively;CRP value diagnostic infection cut-off point is 16.35 mg / dL,AUC is 0.812,sensitivity and specificity are 71.9% and 82.5%.The median PCT values of stage I,II,III and IV were 0.025 ng/mL,0.045 ng/mL,0.031 ng/mL and 0.067 ng/mL,respectively.The PCT value of stage IV was higher than that of stage I-III(P<0.05).),there was no statistical difference during I,II,III(P>0.05).Compared with no metastasis,lung and brain metastasis did not affect PCT values.When liver,bone,other parts and multiple sites were metastasized,PCT values increased,with statistical difference(P<0.05).The PCT values after transfer ranged from 0.05 to 0.074 ng/mL,both below 0.1 ng/mL.Conclusion: Patients with malignant tumors are mainly in the late stage,and local infections are more common in infected patients.PCT is a good indicator of infection in patients with malignant tumors.It can distinguish between infection and non-infection as well as bloodstream infection and local infection,and is basically unaffected by the general condition of cancer patients. |
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