de Lucio Delgado Ana, Villegas Rubio Jose Antonio, Rey Galan Corsino, Prieto García Belen, González Expósito Maria de Los Reyes, Solís Sánchez Gonzalo
Pediatric Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.
Pediatric Intensive Care, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.
Children (Basel). 2021 Nov 9;8(11):1027. doi: 10.3390/children8111027.
We investigated the kinetics of CRP, PCT, IL-6 and MR-proADM in a cohort of consecutive febrile patients with cancer in order to test the hypothesis that higher plasma concentrations and the absence of a rapid decrease in peak values would be associated with disease severity. (1) Method: A prospective descriptive and analytical study of patients with cancer and fever (≤18 years of age) at a University Hospital was carried out between January 2018 and December 2019. Information collected: sex, age, diagnosis, date and symptoms at diagnosis and medical history. The episodes were classified into three groups: bacterial infection, non-bacterial infection and systemic inflammatory response syndrome (SIRS). (2) Results: One hundred and thirty-four episodes were included. Bacterial infection criteria were met in 38 episodes. Biomarkers were measured at four different points: baseline, at 12-24 h, at 25-48 h and at 49-72 h. All the biomarkers evaluated decreased after the peak level was reached. IL-6 and MR-proADM showed a trend towards higher levels in the SIRS group although this rise was statistically significant only for IL-6 ( < 0.005). Bacterial infections more frequently presented values of PCT above the cut-off point (>0.5 ng/mL) at 12-24 h. (3) Conclusion: In our experience, IL-6 kinetics is faster than PCT kinetics and both are faster than CRP in patients with fever and cancer who present a good outcome. Patients with a good evolution show a rapid increase and decrease of PCT and particularly of IL-6 levels.
我们对一组连续的癌症发热患者的CRP、PCT、IL-6和MR-proADM的动力学进行了研究，以检验以下假设：较高的血浆浓度以及峰值无快速下降与疾病严重程度相关。（1）方法：于2018年1月至2019年12月在一家大学医院对癌症发热（≤18岁）患者进行了一项前瞻性描述性和分析性研究。收集的信息包括：性别、年龄、诊断、诊断日期和症状以及病史。这些发作被分为三组：细菌感染、非细菌感染和全身炎症反应综合征（SIRS）。（2）结果：纳入了134次发作。38次发作符合细菌感染标准。在四个不同时间点测量生物标志物：基线、12 - 24小时、25 - 48小时和49 - 72小时。所有评估的生物标志物在达到峰值水平后均下降。IL-6和MR-proADM在SIRS组中显示出水平升高的趋势，尽管这种升高仅对IL-6具有统计学意义（<0.005）。细菌感染在12 - 24小时时更频繁地出现PCT值高于临界值（>0.5 ng/mL）的情况。（3）结论：根据我们的经验，在预后良好的发热癌症患者中，IL-6的动力学比PCT的动力学更快，且两者都比CRP更快。病情进展良好的患者PCT尤其是IL-6水平迅速升高和下降。
