title: Role of procalcitonin in diagnosis of bacterial infection in trans-arterial chemoembolisation treated hepatocellular carcinoma patients.
abstract: OBJECTIVE
  Trans-arterial chemoembolisation (TACE) became the treatment of choice for multinodular hepatocellular carcinoma. The use of prophylactic antibiotics following intervention is controversial. This study aimed to assess the role of serum procalcitonin level in early diagnosis of bacterial infection following TACE to optimise antibiotic intake in those patients.
  
  
  METHODS
  This study was carried on HCC patients diagnosed according to AASLD who underwent TACE and developed post interventional fever within 48 h. Laboratory investigations including CBC, neutrophil count, C-reactive protein and ESR (pre and after intervention) were done. Cultures were done according to the suspected site of infection. Serum procalcitonin was done for all the included patients before and after TACE.
  
  
  RESULTS
  Forty two TACE treated patients were included with post interventional fever within 48 h. Their ages ranged between 45 and 65 (mean 53.83 ± 5.23). All patients received antibiotic prophylaxis started 24h pre intervention and for 5 days after according to the local protocol. Five patients (11.9%) had positive blood cultures post intervention. The analysis of laboratory results showed statistical significant correlation between procalcitonin levels and positive cultures, post interventional CRP and TLC and pre interventional INR and bilirubin, while there was statistical significant correlation between CRP and post interventional temperature, total leucocytic count and site of focal lesion.
  
  
  CONCLUSIONS
  Procalcitonin seems to be a promising marker for diagnosis of sepsis in TACE treated HCC patients to optimise the unnecessary use of antibiotics.
authors: Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Hesham K
authors: HK
authors: Dabbous
authors: Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Fatma A
authors: FA
authors: Ali-Eldin
authors: Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Iman M F
authors: IM
authors: Montasser
mesh_terms: D000368:Aged; D019072:Antibiotic Prophylaxis / Q000379:methods; D001424:Bacterial Infections / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects* / Q000379:methods; D015331:Cohort Studies; D004317:Doxorubicin / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D012380:Role; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D004317:Doxorubicin; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
keywords: Hepatocellular carcinoma; Procalcitonin; Trans-arterial chemoembolisation