Prognostic value of procalcitonin in infection-related mortality of cancer patients

• Published in: Journal of B.U. ON. Vol. 21; no. 3; p. 740
• Main Authors: Murat Sedef, Ali, Kose, Fatih, Taner Sumbul, Ahmet, Dogan, Ozlem, Kursun, Ebru, Yurdakul, Zafer, Sumbul Gultepe, Bilge, Mertsoylu, Huseyin, Sezer, Ahmet, Ozyilkan, Ozgur
• Format: Journal Article
• Language: English
• Published: Greece 01-05-2016
• Subjects: Adult; Aged; Aged, 80 and over; Biomarkers - blood; Calcitonin - blood; Female; Humans; Infection - blood; Infection - mortality; Male; Middle Aged; Neoplasms - mortality; Prognosis
• ISSN: 1107-0625

Infectious diseases are a major cause of morbidity and mortality in cancer patients. Tumor-induced inflammatory responses may increase the value of classical inflammatory markers in blood, so these markers may not be as useful in cancer patients as in non-cancer patients. Serum procalcitonin (PCT) is a sensitive and specific biomarker for severe infection, and has been shown to be unaffected by tumor-induced inflammatory response. In this study we aimed to evaluate the possible role of PCT in mortality in cancer patients with infection.
In total, 104 consecutive adult cancer patients who presented with fever (body temperature ≥ 38.3° C or ≥ 38° C on two consecutive measurements) during follow-up and needing hospitalization for infection were enrolled in this study.
The majority (72%) of the patients were male. The most common diagnosis and type of infection were lung cancer (40.4%) and pneumonia (56.7%), respectively. The overall mortality rate was 17%. Statistical analysis showed a significant relationship between PCT levels and mortality (p=0.001), but not between classical inflammatory markers and mortality (p>0.05). The mortality rate of patients with a PCT value > 2 ng/mL was 34.3%, compared with 9.6% in patients with a PCT below this value (p=0.005). Furthermore, PCT predicted in-ward cancer patient mortality with a sensitivity of 66% and a specificity of 76%.
PCT is a unique serum biomarker significantly related to infection-related mortality and predicts mortality with a relatively high sensitivity and specificity.