Lee Min-Jung, Han Won-Ho, Chun June-Young, Kim Sun-Young, Kim Jee-Hee
National Cancer Center, Department of Surgery, Goyang 410-769, Korea.
National Cancer Center, Department of Internal Medicine, Goyang 410-769, Korea.
J Clin Med. 2021 May 16;10(10):2153. doi: 10.3390/jcm10102153.
Early diagnosis of sepsis is paramount to effective management. The present study aimed to compare the prognostic accuracy of presepsin levels and other biomarkers in the assessment of septic shock and mortality risk in cancer patients.
A total of 74 cancer patients were evaluated for presepsin, lactic acid, C-reactive protein (CRP) levels, and white blood cell count (WBC). Specificity and sensitivity values for septic shock and death were compared between four biomarkers in all patients and those with and without acute kidney injury (AKI).
A total of 27 and 29 patients experienced septic shock and died, respectively. The area under the curve (AUC) and sensitivity and specificity estimated for presepsin levels for septic shock were 60%, 74%, and 51%, respectively. The corresponding values for mortality were 62%, 72%, and 49%, respectively. In patients without AKI, AUC of presepsin levels for septic shock and death were 62% and 65%, respectively; in those with AKI, these values were 44% and 58%, respectively. Presepsin levels showed higher sensitivity and specificity values than WBC and higher specificity than CRP but were similar to those of lactic acid levels.
Presepsin levels are similar to lactic acid levels in the assessment of septic shock and mortality risk in cancer patients. In patients with AKI, presepsin levels should be considered carefully.
脓毒症的早期诊断对于有效治疗至关重要。本研究旨在比较前降钙素水平和其他生物标志物在评估癌症患者感染性休克和死亡风险方面的预后准确性。
共评估了74例癌症患者的前降钙素、乳酸、C反应蛋白（CRP）水平和白细胞计数（WBC）。比较了所有患者以及有和无急性肾损伤（AKI）患者中四种生物标志物对感染性休克和死亡的特异性和敏感性值。
分别有27例和29例患者发生感染性休克和死亡。前降钙素水平对感染性休克的曲线下面积（AUC）、敏感性和特异性估计值分别为60%、74%和51%。对死亡率的相应值分别为62%、72%和49%。在无AKI的患者中，前降钙素水平对感染性休克和死亡的AUC分别为62%和65%；在有AKI的患者中，这些值分别为44%和58%。前降钙素水平显示出比WBC更高的敏感性和特异性值，比CRP更高的特异性，但与乳酸水平相似。
在前降钙素水平在评估癌症患者感染性休克和死亡风险方面与乳酸水平相似。在有AKI的患者中，应谨慎考虑前降钙素水平。
