Procalcitonin as diagnostic marker of infection in solid tumors patients with fever.
In oncologic patients fever is a non-specific clinical marker of different clinical settings. Procalcitonin (PCT) seems to be the most promising infection marker. We aimed to define the potential role of PCT as an earlier diagnostic marker in patients with fever and solid tumor. This retrospective study enrolled 431 patients. All of them performed hemoculture (HE) and basal PCT assessment (reference laboratory cut-off: ≤0.5 or >0.5 ng/dL) before starting antibiotic therapy. Gram positive (G+), negative (G-) or Fungi infection were detected. A statistically significant difference in PCT levels between patients with positive and negative HE was observed (P < 0.0001). Moreover comparing PCT values in patients with positive and negative HE, we obtain in the positive HE subpopulation an AUC of 0.7 and a cut-off of 1.52 ng/dL reached high sensitivity (61.6%) and specificity (70.1%). Using this last cut-off, instead of the normal reference value, we achieve a risk reduction to overestimate an infection status of 23.4%. We support the clinic usefulness of serum PCT dosage in febrile advanced solid tumor patients. A PCT cut-off of 1.52 ng/dL could be helpful in the management of the antibiotic therapy preventing delays of oncologic treatments.
Medical Oncology, University Campus Bio-Medico of Rome, Rome, Italy.
B
B
Vincenzi
Medical Oncology, University Campus Bio-Medico of Rome, Rome, Italy.
I
I
Fioroni
Medical Oncology, University Campus Bio-Medico of Rome, Rome, Italy.
F
F
Pantano
Clinical Pathology and Microbiology Laboratory, University Campus Bio-Medico of Rome, Rome, Italy.
S
S
Angeletti
Clinical Pathology and Microbiology Laboratory, University Campus Bio-Medico of Rome, Rome, Italy.
G
G
Dicuonzo
Medical Oncology, University Campus Bio-Medico of Rome, Rome, Italy.
A
A
Zoccoli
Medical Oncology, University Campus Bio-Medico of Rome, Rome, Italy.
D
D
Santini
Medical Oncology, University Campus Bio-Medico of Rome, Rome, Italy.
G
G
Tonini
D000293:Adolescent; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D000071997:Blood Culture; D002116:Calcitonin / Q000097:blood*; D005260:Female; D005334:Fever / Q000209:etiology*; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000175:diagnosis*; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications / Q000175:diagnosis*; D009369:Neoplasms / Q000150:complications* / Q000473:pathology; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
D015415:Biomarkers; D002116:Calcitonin