Serum procalcitonin levels are elevated in esophageal cancer patients with postoperative infectious complications.
BACKGROUND
The normal systemic inflammatory response to surgical stimuli often makes early diagnosis of postoperative infections difficult.


OBJECTIVE
We investigated whether serum procalcitonin (PCT) levels may be a useful marker of bacterial infections in patients after invasive surgery.


METHODS
The subjects were 40 patients who had undergone radical surgery for esophageal carcinoma by a right thoracoabdominal approach. Nine patients were diagnosed to have a postoperative infection during the first 7 days after surgery. Changes in serum PCT levels were compared between the group diagnosed to have postoperative infection (infection group) and the group without infection (noninfection group).


RESULTS
The postoperative serum PCT levels were significantly higher in the infection group than in the noninfection group (ANOVA: p < 0.01). Serum PCT peaked on postoperative day (POD) 5 in the infection group (8.7 +/- 8.2 ng/ml, mean +/- SD) and on POD 1 in the noninfection group (0.5 +/- 0.5 ng/ml). No significant differences were found between the two groups in leukocyte count, serum CRP or cytokine levels. The receiver operating characteristics (ROC) curve was constructed for infection identification. The area under the ROC curve for peak postoperative PCT was 0.968, and at a cutoff value of 2.0 ng/ml, the sensitivity was 89% and the specificity was 93%.


CONCLUSIONS
Serum PCT levels may be useful for the early diagnosis of postoperative infectious complications.
Ito
S
S
Department of Surgery 1, Critical Care Medicine and Anesthesiology, School of Medicine, Iwate Medical University, Morioka, Japan.
Sato
N
N
Kojika
M
M
Yaegashi
Y
Y
Suzuki
Y
Y
Suzuki
K
K
Endo
S
S
D000368:Aged; D001424:Bacterial Infections / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood*; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D017472:Receptors, Interleukin-1 / Q000037:antagonists & inhibitors; D012189:Retrospective Studies
C000606589:CALCA protein, human; D015850:Interleukin-6; D016209:Interleukin-8; D011498:Protein Precursors; D017472:Receptors, Interleukin-1; D016753:Interleukin-10; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide