Ebihara Yasuhiro, Kobayashi Kiyoko, Ishida Akaru, Maeda Tomoya, Takahashi Naoki, Taji Yoshitada, Asou Norio, Ikebuchi Kenji
Department of Laboratory Medicine, International Medical Center, Saitama Medical University, Saitama, Japan.
Department of Transfusion Medicine and Cell Transplantation, International Medical Center, Saitama Medical University, Saitama, Japan.
J Clin Lab Anal. 2017 Nov;31(6). doi: 10.1002/jcla.22147. Epub 2017 Jan 30.
Infections represent a major complication of hematological malignancies. C-reactive protein (CRP) and procalcitonin (PCT) have been used as diagnostic biomarkers of infections, but do not produce definitive findings. Recently, a new biomarker, presepsin, has been used as a diagnostic tool for detecting infections in the fields of emergency and neonatal medicine. However, the usefulness of presepsin for identifying infections in patients with hematological malignancies, including those who develop febrile neutropenia, remains unclear.
In this study, we retrospectively analyzed the utility of PCT, presepsin, and CRP as biomarkers of infections during 49 febrile episodes that occurred in 28 patients with hematological malignancies.
The levels of PCT, but not those of CRP or presepsin, were significantly higher in the infection group than in the uninfected group (P<.03), indicating that PCT might be a more sensitive biomarker of infections. No differences in presepsin levels were detected between the patients with and without neutropenia, or between the infected and uninfected patients with neutropenia, indicating that presepsin might have less diagnostic value in patients with neutropenia.
We conclude that PCT might provide additional information and could be used in combination with other biomarkers to detect infections in patients with hematological malignancies.
感染是血液系统恶性肿瘤的主要并发症。C反应蛋白(CRP)和降钙素原(PCT)已被用作感染的诊断生物标志物,但未得出明确结果。最近,一种新的生物标志物——可溶性髓系细胞触发受体-1(presepsin),已被用作急诊医学和新生儿医学领域检测感染的诊断工具。然而,presepsin在识别血液系统恶性肿瘤患者(包括发生发热性中性粒细胞减少症的患者)感染中的效用仍不明确。
在本研究中,我们回顾性分析了28例血液系统恶性肿瘤患者发生的49次发热发作期间,PCT、presepsin和CRP作为感染生物标志物的效用。
感染组的PCT水平显著高于未感染组(P<0.03),而CRP和presepsin水平则无显著差异,这表明PCT可能是一种更敏感的感染生物标志物。在有或无中性粒细胞减少症的患者之间,以及在有中性粒细胞减少症的感染和未感染患者之间,未检测到presepsin水平的差异,这表明presepsin在中性粒细胞减少症患者中的诊断价值可能较小。
我们得出结论,PCT可能提供额外信息,并可与其他生物标志物联合使用,以检测血液系统恶性肿瘤患者的感染。