Abstract：
OBJECTIVE: Patients with advanced cancer may develop bacterial infections (BI) as their general condition worsens, but general blood tests often find it difficult to distinguish them from non-bacterial infections (NBI). The present prospective study was undertaken to investigate the effectiveness of serum procalcitonin levels in distinguishing between BI and NBI in patients with advanced urological cancer.
METHODS: This study prospectively evaluated patients diagnosed with locally advanced or metastatic or recurrent urological cancer in our department from September 2013 to December 2019. Body temperature was measured in the axilla and the measurement results were recorded. Febrile episodes of ≥38.0°C were analysed, and written patient consent was obtained at the onset of the fever.
RESULTS: Of 75 patients enrolled in the present study, 90 febrile episodes were analysed. A total of 34 of 90 febrile episodes were regarded as BI, and the remaining 56 febrile episodes as NBI. The median procalcitonin value was significantly higher in the BI group (p=0.0015), while no significant difference was found between the two groups for white blood cell count and C reactive protein. Additionally, a white blood cell count of less than 1.0×10ˆ9/L resulted in BI in all cases. The procalcitonin receiver operating characteristic area under the curve was 0.710 (95% CI 0.586 to 0.83), excluding cases with white blood cell counts of <1.0 × 103/μL.
CONCLUSIONS: Procalcitonin is a rapid and affordable marker for differentiation between BI and NBI in patients with advanced urological cancer.
METHODS: This study prospectively evaluated patients diagnosed with locally advanced or metastatic or recurrent urological cancer in our department from September 2013 to December 2019. Body temperature was measured in the axilla and the measurement results were recorded. Febrile episodes of ≥38.0°C were analysed, and written patient consent was obtained at the onset of the fever.
RESULTS: Of 75 patients enrolled in the present study, 90 febrile episodes were analysed. A total of 34 of 90 febrile episodes were regarded as BI, and the remaining 56 febrile episodes as NBI. The median procalcitonin value was significantly higher in the BI group (p=0.0015), while no significant difference was found between the two groups for white blood cell count and C reactive protein. Additionally, a white blood cell count of less than 1.0×10ˆ9/L resulted in BI in all cases. The procalcitonin receiver operating characteristic area under the curve was 0.710 (95% CI 0.586 to 0.83), excluding cases with white blood cell counts of <1.0 × 103/μL.
CONCLUSIONS: Procalcitonin is a rapid and affordable marker for differentiation between BI and NBI in patients with advanced urological cancer.
摘要：
目的：晚期癌症患者随着一般情况的恶化，可能会出现细菌感染（BI）。但是一般的血液检查通常很难将它们与非细菌感染（NBI）区分开。本前瞻性研究旨在研究血清降钙素原水平在区分晚期泌尿系癌症患者的BI和NBI中的有效性。
方法：本研究前瞻性评估了2013年9月至2019年12月在我科诊断为局部晚期或转移性或复发性泌尿系癌症的患者。测量腋窝的体温并记录测量结果。分析≥38.0°C的发热发作，并且在发烧开始时获得了患者的书面同意。
结果：在本研究的75名患者中，分析了90次发热发作。90次高热发作中共有34次被视为BI，其余56次发热发作为NBI。BI组的降钙素原中值显著较高(p=0.0015),而两组白细胞计数和C反应蛋白无显著差异。此外,在所有情况下，白细胞计数低于1.0×101991/L导致BI。降钙素原受试者工作特征曲线下面积为0.710（95%CI0.586～0.83），排除白细胞计数<1.0×103/μL的病例。
结论：降钙素原是区分晚期泌尿系肿瘤患者BI和NBI的快速且经济的标志物。
方法：本研究前瞻性评估了2013年9月至2019年12月在我科诊断为局部晚期或转移性或复发性泌尿系癌症的患者。测量腋窝的体温并记录测量结果。分析≥38.0°C的发热发作，并且在发烧开始时获得了患者的书面同意。
结果：在本研究的75名患者中，分析了90次发热发作。90次高热发作中共有34次被视为BI，其余56次发热发作为NBI。BI组的降钙素原中值显著较高(p=0.0015),而两组白细胞计数和C反应蛋白无显著差异。此外,在所有情况下，白细胞计数低于1.0×101991/L导致BI。降钙素原受试者工作特征曲线下面积为0.710（95%CI0.586～0.83），排除白细胞计数<1.0×103/μL的病例。
结论：降钙素原是区分晚期泌尿系肿瘤患者BI和NBI的快速且经济的标志物。
