Procalcitonin and C-Reactive Protein/Procalcitonin Ratio as Markers of Infection in Patients With Solid Tumors
Objectives: The roles of procalcitonin (PCT) and C-reactive protein (CRP) in febrile cancer patients is currently unclear. Our aim was to assess these in febrile patients with solid tumors and to identify cut-off values for ruling out infection.Methods: We retrospectively evaluated patients with sol...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-03-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.627967/full |
| _version_ | 1818575970635874304 |
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| author | Matteo Vassallo Celine Michelangeli Roxane Fabre Sabrina Manni Pierre L. Genillier Nicolas Weiss Elea Blanchouin Laurence Saudes Regis Kaphan Annick Puchois Christian Pradier Nathalie Montagne |
| author_facet | Matteo Vassallo Celine Michelangeli Roxane Fabre Sabrina Manni Pierre L. Genillier Nicolas Weiss Elea Blanchouin Laurence Saudes Regis Kaphan Annick Puchois Christian Pradier Nathalie Montagne |
| author_sort | Matteo Vassallo |
| collection | DOAJ |
| description | Objectives: The roles of procalcitonin (PCT) and C-reactive protein (CRP) in febrile cancer patients is currently unclear. Our aim was to assess these in febrile patients with solid tumors and to identify cut-off values for ruling out infection.Methods: We retrospectively evaluated patients with solid tumors admitted to hospital due to fever. They were divided into those with Fever with microbiologically documented infection (FMDI), Fever with clinically documented infection (FCDI) and Tumor-related fever (TRF). PCT and CRP levels were compared. Receiver-operating curves were plotted to define the best cut-off values for discriminating between infection-related and cancer-related fever.Results: Between January 2015 to November 2018, 131 patients were recorded (mean age 68 years, 67% male, 86% with metastasis). Patients with FMDI or FCDI had significantly higher baseline levels of PCT and lower CRP/PCT than those with TRF. A PCT cut-off value of 0.52 ng/mL for discriminating between infection and cancer-associated fever yielded 75% sensitivity, 55% specificity, 77% positive predictive value (PPV), and 52% negative predictive value (NPV). A CRP/PCT ratio with a cut-off value of 95 showed 56% sensitivity, 70% specificity, 79% NPV, and 44% PPV.Discussion: PCT is a sensitive marker of sepsis or localized infection in patients with solid tumors, but its specificity is poor. The CRP/PCT ratio improves specificity, thus providing a reliable means of ruling out infection for values above 95. |
| first_indexed | 2024-12-15T00:48:05Z |
| format | Article |
| id | doaj.art-1cf09299add54f6b8f7c6c13320ab139 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-15T00:48:05Z |
| publishDate | 2021-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-1cf09299add54f6b8f7c6c13320ab1392022-12-21T22:41:30ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-03-01810.3389/fmed.2021.627967627967Procalcitonin and C-Reactive Protein/Procalcitonin Ratio as Markers of Infection in Patients With Solid TumorsMatteo Vassallo0Celine Michelangeli1Roxane Fabre2Sabrina Manni3Pierre L. Genillier4Nicolas Weiss5Elea Blanchouin6Laurence Saudes7Regis Kaphan8Annick Puchois9Christian Pradier10Nathalie Montagne11Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, FranceDepartment of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, FranceDepartment of Public Health, L'Archet Hospital, University of Nice, Nice, FranceDepartment of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, FranceDepartment of Medical Informatics, Cannes General Hospital, Cannes, FranceDepartment of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, FranceDepartment of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, FranceDepartment of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, FranceDepartment of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, FranceMultipurpose Laboratory, Bacteriology and Virology Unit, Cannes General Hospital, Cannes, FranceDepartment of Public Health, L'Archet Hospital, University of Nice, Nice, FranceDepartment of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, FranceObjectives: The roles of procalcitonin (PCT) and C-reactive protein (CRP) in febrile cancer patients is currently unclear. Our aim was to assess these in febrile patients with solid tumors and to identify cut-off values for ruling out infection.Methods: We retrospectively evaluated patients with solid tumors admitted to hospital due to fever. They were divided into those with Fever with microbiologically documented infection (FMDI), Fever with clinically documented infection (FCDI) and Tumor-related fever (TRF). PCT and CRP levels were compared. Receiver-operating curves were plotted to define the best cut-off values for discriminating between infection-related and cancer-related fever.Results: Between January 2015 to November 2018, 131 patients were recorded (mean age 68 years, 67% male, 86% with metastasis). Patients with FMDI or FCDI had significantly higher baseline levels of PCT and lower CRP/PCT than those with TRF. A PCT cut-off value of 0.52 ng/mL for discriminating between infection and cancer-associated fever yielded 75% sensitivity, 55% specificity, 77% positive predictive value (PPV), and 52% negative predictive value (NPV). A CRP/PCT ratio with a cut-off value of 95 showed 56% sensitivity, 70% specificity, 79% NPV, and 44% PPV.Discussion: PCT is a sensitive marker of sepsis or localized infection in patients with solid tumors, but its specificity is poor. The CRP/PCT ratio improves specificity, thus providing a reliable means of ruling out infection for values above 95.https://www.frontiersin.org/articles/10.3389/fmed.2021.627967/fullprocalcitoninC-reactive protein/procalcitonin ratiofeverinfectionsolid tumor |
| spellingShingle | Matteo Vassallo Celine Michelangeli Roxane Fabre Sabrina Manni Pierre L. Genillier Nicolas Weiss Elea Blanchouin Laurence Saudes Regis Kaphan Annick Puchois Christian Pradier Nathalie Montagne Procalcitonin and C-Reactive Protein/Procalcitonin Ratio as Markers of Infection in Patients With Solid Tumors Frontiers in Medicine procalcitonin C-reactive protein/procalcitonin ratio fever infection solid tumor |
| title | Procalcitonin and C-Reactive Protein/Procalcitonin Ratio as Markers of Infection in Patients With Solid Tumors |
| title_full | Procalcitonin and C-Reactive Protein/Procalcitonin Ratio as Markers of Infection in Patients With Solid Tumors |
| title_fullStr | Procalcitonin and C-Reactive Protein/Procalcitonin Ratio as Markers of Infection in Patients With Solid Tumors |
| title_full_unstemmed | Procalcitonin and C-Reactive Protein/Procalcitonin Ratio as Markers of Infection in Patients With Solid Tumors |
| title_short | Procalcitonin and C-Reactive Protein/Procalcitonin Ratio as Markers of Infection in Patients With Solid Tumors |
| title_sort | procalcitonin and c reactive protein procalcitonin ratio as markers of infection in patients with solid tumors |
| topic | procalcitonin C-reactive protein/procalcitonin ratio fever infection solid tumor |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.627967/full |
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