Chen Ying, Qin Tao, Chen Yan, Gao Ming
Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Medical Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Front Oncol. 2023 Jan 13;12:1047738. doi: 10.3389/fonc.2022.1047738. eCollection 2022.
Ewing sarcoma (ES) represents a rare, aggressive bone and soft-tissue cancer. Unlike breast, liver, pancreatic, and prostate cancers, Ewing sarcoma has had no representative tumor marker until now. The use of procalcitonin (PCT) as a tumor marker is also rarely reported. PCT is a clinically recognized and widely used inflammatory marker in recent years. In rare cases, PCT may also be falsely positive due to non-infectious factors. In the few previously reported papers regarding the correlation between tumors and PCT, we learned that abnormalities of PCT level can also be impacted by individual cancers.
Here, we first reported a case of Ewing sarcoma with markedly elevated PCT without infection and carried out some literature review. The patient was a middle-aged man with extraskeletal Ewing sarcoma whose lesion was located in the distal abdominal ileum. He had a sudden and unprovoked onset of high fever during chemotherapy before surgery. After multiple examinations, the patient's blood routine, C-reactive protein, blood culture, and CT examination showed no signs of infection, and even the culture from the end of the central venous catheter showed no pathogen growth. Only PCT increased dramatically to more than 200 ng/ml. PCT remained at this level for several months until a single abdominal lumpectomy was performed before it dropped to near-normal levels.
In our report, PCT is significantly elevated in Ewing sarcoma in the absence of infection. Not only that, but we particularly highlighted the precipitous drop in PCT following tumor resection.
尤因肉瘤（ES）是一种罕见的侵袭性骨与软组织癌症。与乳腺癌、肝癌、胰腺癌和前列腺癌不同，尤因肉瘤至今尚无代表性的肿瘤标志物。降钙素原（PCT）作为肿瘤标志物的应用也鲜有报道。PCT是近年来临床上公认且广泛应用的炎症标志物。在罕见情况下，PCT也可能因非感染因素而出现假阳性。在之前少数几篇关于肿瘤与PCT相关性的报道中，我们了解到PCT水平异常也可能受到个别癌症的影响。
在此，我们首次报道了一例尤因肉瘤患者，其PCT显著升高且无感染，并进行了一些文献回顾。该患者为一名中年男性，患有骨外尤因肉瘤，病变位于回肠末端腹部。术前化疗期间，他突然无故高热。经过多次检查，患者的血常规、C反应蛋白、血培养及CT检查均未显示感染迹象，甚至中心静脉导管末端培养也未发现病原体生长。只有PCT急剧升高至超过200 ng/ml。PCT在该水平持续数月，直到进行了一次腹部肿块切除术后才降至接近正常水平。
在我们的报道中，尤因肉瘤患者在无感染情况下PCT显著升高。不仅如此，我们特别强调了肿瘤切除后PCT的急剧下降。
