Value of procalcitonin quick test in the differentiation between sterile and infected forms of acute pancreatitis.
OBJECTIVE
Authors analyzed the clinical value of procalcitonin quick test (PCT-Q; BRAHMS Diagnostica, GmbH, Berlin) in infected pancreas necrosis verified by guided fine-needle aspiration (FNA).


METHODS
In the prospective, controlled study data of 24 patients were evaluated. PCT-Q was performed in patients with necrosis--verified on computer tomography (CT scan)--and/or sepsis. If PCT-Q test was positive or septic complication (infected necrosis or abscess) developed, CT or ultrasound (US) guided fine-needle aspiration was performed with Gram staining and bacteriology. Positive FNA result was indication for surgery with repeated staining and bacteriology of the surgical specimen.


RESULTS
Septic complications developed in 12 patients. Analyzing the results, fine-needle aspiration was more authentic with 92% sensitivity and 100% specificity, while sensitivity of PCT-Q test remained 75% and its specificity 83%. Comparing abscess with infected necrosis significantly higher procalcitonin values were detected in patients with necrosis.


CONCLUSIONS
These results show that PCT-Q test is a possible non-invasive method which can be used besides fine-needle aspiration. Elevated levels of procalcitonin (higher than 2ng/mL) clearly suggest infection, while lower values do not exclude the possibility of local sepsis.
Oláh
Attila
A
Department of Surgery, Petz Aladar Teaching Hospital, Gyor, Hungary. olah.seb@arrabonet.gyor.hu
Belágyi
Tibor
T
Issekutz
Akos
A
Makay
Roland
R
Zaborszky
Andras
A
D000328:Adult; D000368:Aged; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002177:Candidiasis / Q000175:diagnosis; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis; D006403:Hematologic Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D015203:Reproducibility of Results
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide