title: Diagnostic and prognostic value of serum procalcitonin concentrations in primary lung cancers.
abstract: OBJECTIVE
  Procalcitonin (PCT) is widely used for the diagnosis of bacterial infections. The aim of this study was to evaluate PCT as a tumor and as a prognostic marker in patients with primary lung cancer.
  
  
  METHODS
  We retrospectively performed a PCT dosage in the frozen serum samples of 147 patients with pulmonary neoplasia for whom a test of neuron-specific enolase (NSE) had been conducted at the time of diagnosis.
  
  
  RESULTS
  We show that a PCT serum level above 0.15 ng/mL was independently linked to the presence of a neuroendocrine component in the tumor (HR=5.809 95% CI [1.695-19.908] p: 0005). Thus, median PCT serum levels were significantly more elevated in small-cell lung cancers than in pulmonary adenocarcinomas: 0.33 ng/mL versus 0.07 ng/mL (p<0.001). However, the diagnostic value of serum PCT levels for diagnosing carcinoma with a neuroendocrine component remains low (sensitivity 63.8%; specificity 71.9%). In this series, serum PCT levels were significantly more elevated in the presence of liver metastases: 0.37 ng/mL versus 0.09 ng/mL in the absence of liver metastasis (p<0.001). In uni- and multivariate analyses, a serum PCT level above 0.15n g/mL and the presence of metastases and of sepsis at the time of diagnosis were independent factors of unfavorable prognosis.
  
  
  CONCLUSIONS
  Serum PCT is elevated in patients with lung cancer with neuroendocrine component or with liver metastases. As a consequence, in this population, PCT has a poor specificity for bacterial infection. At diagnosis, an elevated serum PCT is an independent predictive factor of bad prognosis.
authors.affiliation: Clinique Pneumologique, Hôpital Charles Nicolle, CHU de Rouen, 1 rue de Germont, 76031 Rouen Cedex, France. Electronic address: Maxime.patout@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Patout
authors.affiliation: Clinique Pneumologique, Hôpital Charles Nicolle, CHU de Rouen, 1 rue de Germont, 76031 Rouen Cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Salaün
authors.affiliation: Institut de Biologie Clinique, Hôpital Charles Nicolle, CHU de Rouen, 1 rue de Germont, 76031 Rouen Cedex, France.
authors.forename: V
authors.initials: V
authors.lastname: Brunel
authors.affiliation: Clinique Pneumologique, Hôpital Charles Nicolle, CHU de Rouen, 1 rue de Germont, 76031 Rouen Cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Bota
authors.affiliation: Institut de Biologie Clinique, Hôpital Charles Nicolle, CHU de Rouen, 1 rue de Germont, 76031 Rouen Cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Cauliez
authors.affiliation: Clinique Pneumologique, Hôpital Charles Nicolle, CHU de Rouen, 1 rue de Germont, 76031 Rouen Cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Thiberville
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood / Q000556:secondary; D008175:Lung Neoplasms / Q000097:blood* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018358:Neuroendocrine Tumors / Q000097:blood / Q000175:diagnosis; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055752:Small Cell Lung Carcinoma / Q000097:blood / Q000175:diagnosis
chemical_list: D014408:Biomarkers, Tumor; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
keywords: Liver metastasis; Non-small-cell lung cancer; Procalcitonin; Prognostic factor; Small-cell lung cancer