title: Procalcitonin as a predictive marker for surgical site infection in elective colorectal cancer surgery.
abstract: OBJECTIVE
  Surgical site infection (SSI) is a frequent complication of elective surgery for colorectal cancer. The classical clinical markers of infection-elevations in white blood cell count, C-reactive protein (CRP) level, and body temperature-do not precisely predict SSI after elective colorectal resection. The objective of this study was to evaluate the efficacy of procalcitonin (PCT) as a tool for diagnosis of SSI in elective surgery for colorectal cancer.
  
  
  METHODS
  A total of 114 consecutive patients undergoing elective colorectal resection for cancer were evaluated. Routine blood samples, for determining PCT level, CRP plasma concentration, and white blood cell count, were obtained on postoperative days (POD) 1 and 3. Predictive values for each of the laboratory markers were examined.
  
  
  RESULTS
  SSI was diagnosed in 18 (15.7 %) of 114 patients. Patients with SSI exhibited significantly higher PCT levels (on PODs 1 and 3) and CRP levels (on POD 3) than did patients without SSI. According to receiver operating characteristic analysis, PCT showed the highest area under the curve (AUC) for predicting SSI on both PODs 1 and 3 (AUC, 0.76 and 0.77, respectively). Multivariate logistic regression analysis showed that PCT (on PODs 1 and 3) was an independent predictor for SSI (odds ratio = 14.41 and 9.79, respectively).
  
  
  CONCLUSIONS
  Serum PCT is more reliable laboratory marker for the early diagnosis of SSI after elective colorectal cancer surgery, compared with conventional inflammatory indicators. PCT could serve as an additional diagnostic tool for the early identification of SSI to improve clinical decision making.
authors.affiliation: Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. ytaka0621@gmail.com
authors.forename: Yuji
authors.initials: Y
authors.lastname: Takakura
authors.forename: Takao
authors.initials: T
authors.lastname: Hinoi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Egi
authors.forename: Manabu
authors.initials: M
authors.lastname: Shimomura
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Adachi
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Saito
authors.forename: Naoki
authors.initials: N
authors.lastname: Tanimine
authors.forename: Masashi
authors.initials: M
authors.lastname: Miguchi
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis* / Q000378:metabolism; D002116:Calcitonin / Q000032:analysis / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D015331:Cohort Studies; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D042241:Early Diagnosis; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D005334:Fever / Q000175:diagnosis; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D011498:Protein Precursors / Q000032:analysis / Q000097:blood*; D012372:ROC Curve; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000097:blood* / Q000175:diagnosis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D018836:Inflammation Mediators; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide