Yaegashi Hiroshi, Izumi Kouji, Kitagawa Yasuhide, Kadono Yoshifumi, Konaka Hiroyuki, Mizokami Atsushi, Namiki Mikio
Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan.
Int J Urol. 2014 Jan;21(1):104-6. doi: 10.1111/iju.12178. Epub 2013 Apr 21.
It is difficult to determine the cause of high fever in patients with advanced cancer, because they tend to have both neoplastic fever and concomitant bacterial infections with elevated white blood cells and C-reactive protein levels. Procalcitonin has been reported to be a valuable marker for bacterial infections in a wide range of clinical scenarios. However, there have been no studies regarding the usefulness of procalcitonin to differentiate between febrile episodes caused by bacterial infections and neoplastic fever in patients with advanced urological cancer. In the present study, 37 febrile episodes were retrospectively analyzed. Although there were no differences in white blood cell number, C-reactive protein level or body temperature between bacterial infections and non-bacterial infections, procalcitonin levels were significantly higher in the former than the latter. Our findings suggest that measurement of procalcitonin might be valuable to determine the cause of febrile episodes in patients with advanced urological cancer, and can help clinicians to make appropriate decisions for treatment.
很难确定晚期癌症患者高烧的病因，因为他们往往既有肿瘤热，又伴有细菌感染，白细胞和C反应蛋白水平会升高。据报道，降钙素原在广泛的临床情况下是细菌感染的一个有价值的标志物。然而，关于降钙素原在区分晚期泌尿系统癌症患者由细菌感染引起的发热发作和肿瘤热方面的有用性，尚无相关研究。在本研究中，对37次发热发作进行了回顾性分析。虽然细菌感染和非细菌感染之间白细胞数量、C反应蛋白水平或体温没有差异，但前者的降钙素原水平明显高于后者。我们的研究结果表明，检测降钙素原可能有助于确定晚期泌尿系统癌症患者发热发作的病因，并有助于临床医生做出适当的治疗决策。
