降钙素原在恶性肿瘤患者发热诊断中的研究

目的探讨降钙素原(PCT)在恶性肿瘤患者发热诊断中的应用价值。方法收集2016年1-10月恶性肿瘤伴发热患者254例,根据临床表现、实验室检查及影像学检查结果明确诊断体温升高的原因进行分组,并比较各组间PCT水平的差异。结果与肿瘤热组相比,败血症组和非败血症组PCT水平显著升高(P0.001)。且无论是细菌感染、真菌感染还是二者混合性感染,PCT水平均明显高于肿瘤热组;与真菌感染组相比,细菌感染性组的PCT水平显著升高(P0.01)。在肿瘤热组、真菌感染组与细菌感染组中,PCT水平的分布差异有统计学意义(P0.01)。PCT诊断真菌感染性发热和细菌感染性发热的临界值分别为0.575、0.945ng/mL,ROC曲线下面积分别为0.812(95%CI:0.805~0.934)、0.951(95%CI:0.917~0.985)。结论初步认为PCT可以作为鉴别恶性肿瘤患者发热原因的一个有效的临床辅助诊断指标。

Investigation on procalcitonin in diagnosis of fever in cancer patients

Objective To investigate the application value of procalcitonin(PCT) in fever of the patients with malignant tumor.Methods A total of 254 patients with malignant tumor complicating fever from January to October 2016 were collected and grouped after clearly diagnosing the causes of body temperature increase according to the clinical manifestations,laboratory examination and imaging examination results.The difference of PCT level was compared among various groups.Results Compared with tumor thermal group,the PCT level in the sepsis and non-sepsis groups was significantly increased(P<0.001).Moreover no matter which was bacterial infection,fungal infection or both mixed infection,the PCT level was significantly higher than that in the tumor thermal group;compared with the fungal infection group,the PCT level in the bacterial infection group was increased significantly(P<0.01).The PCT level distribution difference among the tumor thermal group,fungal infection group and bacterial infection group was statistically significant(P<0.01).The critical values of PCT for diagnosing fungal and bacterial infectious fever were 0.575,0.945 ng/mL respectively.The areas under ROC curve were 0.812(95%CI:0.805-0.934);0.951(95%CI:0.917-0.985).Conclusion It is priliminarily considered that PCT can serve as an effective clinical auxiliary diagnostic indicator for differentiating the fever cause in the patients with malignant tumor.