title: High serum levels of procalcitonin and soluble TREM-1 correlated with poor prognosis in pulmonary tuberculosis.
abstract: OBJECTIVE
  Comparisons of procalcitonin (PCT), C-reactive protein (CRP), and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) would expand our knowledge of which biomarker is the best predictor for outcomes of patients with pulmonary tuberculosis (PTB).
  
  
  METHODS
  We prospectively enrolled 243 PTB patients, in whom PCT, CRP, and sTREM-1 measurement were performed to evaluate their prognostic value for 6-month mortality.
  
  
  RESULTS
  Serum PCT, CRP, and sTREM-1 levels on diagnosis of PTB were significantly higher in nonsurvivors (2.22 ± 6.22 vs. 0.13 ± 0.31 ng/mL, P = 0.043; 42.1 ± 59.4 vs. 12.5 ± 29.1 mg/L, P = 0.004; 332 ± 362 vs. 128 ± 98 pg/mL, P = 0.001, respectively) as compared with 6-month survivors. In multivariate Cox regression analysis, PCT ≧ 0.5 ng/mL (hazard ratio 4.13, 95% CI, 1.99-8.58) and sTREM-1 ≧ 129 pg/mL (hazard ratio 3.39, 95% CI, 1.52-7.58) remained independent mortality predictors. Serum PCT and sTREM-1 levels above the cutoffs were also associated with the presence of disseminated tuberculosis.
  
  
  CONCLUSIONS
  Among PTB patients, higher PCT, CRP, and sTREM-1 levels are observed in nonsurvivors than in 6-month survivors. Serum levels of PCT and sTREM-1 over the cutoffs are independently associated with a poor outcome. In addition, higher PCT and sTREM-1 levels would raise the clinical suspicion of disseminated tuberculosis.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; Department of Traumatology, National Taiwan University Hospital, Taipei 100, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University, Taipei 100, Taiwan.
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Huang
authors.affiliation: Department of Laboratory Medicine, National Taiwan University Hospital, Taipei 100, Taiwan.
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan.
authors.forename: Chao-Chi
authors.initials: CC
authors.lastname: Ho
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; Department of Traumatology, National Taiwan University Hospital, Taipei 100, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University, Taipei 100, Taiwan.
authors.forename: Chin-Chung
authors.initials: CC
authors.lastname: Shu
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan.
authors.forename: Sheng-Yuan
authors.initials: SY
authors.lastname: Ruan
authors.affiliation: School of Medicine, College of Medicine, Fu-Jen Catholic University, Taipei 100, Taiwan.
authors.forename: Yi-Ju
authors.initials: YJ
authors.lastname: Tsai
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan. Electronic address: jywang@ntu.edu.tw.
authors.forename: Jann-Yuan
authors.initials: JY
authors.lastname: Wang
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan.
authors.forename: Chong-Jen
authors.initials: CJ
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D011971:Receptors, Immunologic / Q000097:blood*; D044967:Serum / Q000737:chemistry; D016019:Survival Analysis; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000473:pathology*; D055815:Young Adult
chemical_list: C000606589:CALCA protein, human; D008562:Membrane Glycoproteins; D011498:Protein Precursors; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide
keywords: Biomarker; C-reactive protein; Procalcitonin; Prognosis; Triggering receptor expressed on myeloid cells-1; Tuberculosis