Zhao Zhifang, Li Xuze, Zhao Yunxia, Wang Dongchang, Li Yahua, Liu Le, Sun Tao, Chen Gang
Department of Respiration, The Third Hospital of Hebei Medical University Department of Anesthesiology, The Second Hospital of Hebei Medical University Department of Orthopaedic Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Medicine (Baltimore). 2018 Aug;97(33):e11930. doi: 10.1097/MD.0000000000011930.
This study assessed whether C-reactive protein (CRP) and procalcitonin (PCT) levels can discriminate between infectious fever and tumor fever (TF) in non-neutropenic patients with nonsmall cell lung cancer (NSCLC).This retrospective clinical study included 96 adults with NSCLC who were admitted to the Third Hospital of Hebei Medical University between July 2015 and July 2017. Febrile, non-neutropenic patients were enrolled. CRP and PCT levels, neutrophil count, and antimicrobial response were evaluated.This study included 26 patients with TF, 49 with localized bacterial infection (LBI), and 21 with bloodstream infection (BSI). CRP levels in BSI were significantly higher than in TF (P < .05) and LBI (P < .05). No statistically significant difference was found between patients with TF and LBI (P > .05). PCT levels were significantly higher in BSI and LBI than in TF (P < .05). CRP and PCT levels in patients with stage IV disease were significantly higher than in those with stage II to III disease (P < .05). CRP and PCT levels declined significantly in patients with BSI who were responding to antimicrobials (P < .05).Compared with CRP levels, PCT levels can discriminate between TF and infectious fever more accurately. PCT and CRP levels may predict different stages of lung cancer.
本研究评估了C反应蛋白（CRP）和降钙素原（PCT）水平能否区分非小细胞肺癌（NSCLC）非中性粒细胞减少患者的感染性发热和肿瘤热（TF）。这项回顾性临床研究纳入了2015年7月至2017年7月期间在河北医科大学第三医院住院的96例成年NSCLC患者。纳入发热的非中性粒细胞减少患者。评估了CRP和PCT水平、中性粒细胞计数及抗菌反应。本研究包括26例肿瘤热患者、49例局部细菌感染（LBI）患者和21例血流感染（BSI）患者。BSI患者的CRP水平显著高于肿瘤热患者（P<0.05）和LBI患者（P<0.05）。肿瘤热患者和LBI患者之间未发现统计学显著差异（P>0.05）。BSI和LBI患者的PCT水平显著高于肿瘤热患者（P<0.05）。IV期疾病患者的CRP和PCT水平显著高于II至III期疾病患者（P<0.05）。对抗菌药物有反应的BSI患者的CRP和PCT水平显著下降（P<0.05）。与CRP水平相比，PCT水平能更准确地区分肿瘤热和感染性发热。PCT和CRP水平可能预测肺癌的不同阶段。
