Zhou Qihao, Lu Xuefen, Qian Liping, Yu Chaochao, Xie Jingru, Kong Dexia
Cancer Center, Department of Medical Oncology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Department of Pharmacy, Huzhou Nanxun People's Hospital, Zhejiang Provincial People's Hospital NanXun District, Huzhou, Zhejiang, China.
Medicine (Baltimore). 2024 Dec 6;103(49):e40792. doi: 10.1097/MD.0000000000040792.
Procalcitonin (PCT), C-reactive protein (CRP), and white blood cell count (WBC) are commonly recognized as inflammatory markers. Some studies showed that these markers were also related to some cancers. This study aimed to investigate whether these markers were exhibited aberrations in end-stage cancer patients and to assess their correlation with infection and prognosis. The study underscores the potential of inflammatory markers as prognostic indicators in end-stage cancer, proposing that routine monitoring of these markers could substantially enhance patient management and improve outcomes. The medical records of 116 cancer patients were retrospectively reviewed. Data from end-stage cancer patients were collected during the week preceding their death. The control group consisted of cancer patients with a performance status score of 3 to 4 and clinical stage of III to IV. Normally distributed continuous data (mean ± SD) were analyzed using t-test. Non-normally distributed data (median [M] with interquartile range [P25, P75]) were analyzed using Wilcoxon rank-sum test. Numerical data were subjected to Chi-square test. Logistic regression analysis was employed to assess the correlation between inflammatory markers and patient prognosis. There were significant differences between the 2 groups for PCT, WBC, CRP, platelet count, and body mass index. However, subgroup analysis indicated that there were no significant differences in PCT, CRP, and WBC levels between infected and noninfected patients within the deceased group. It is worth noting that elevated levels of PCT (OR = 7.13, 95% confidence interval [CI] = 1.68-30.36, P = .008) and WBC (OR = 2.47, 95% CI = 1.13-1.13, P = .024) were ultimately identified as independent risk factors associated with poor prognosis in cancer patients, as demonstrated by further logistic regression analysis. In the subgroup analysis of noninfected patients, the univariate analysis revealed that both PCT (OR = 11.612, 95% CI = 1.217-110.776, P = .033) and WBC (OR = 3.077, 95% CI = 1.004-9.427, P = .049) had a statistically significant difference in outcomes between the alive group and the deceased group. The PCT, WBC, and CRP levels of end-stage cancer patients were significantly elevated, regardless of infection. An increase in PCT and WBC was associated with an increased risk of death. These findings suggest that monitoring PCT and WBC levels in end-stage cancer patients may provide valuable prognostic information, aiding in clinical decision-making.
降钙素原（PCT）、C反应蛋白（CRP）和白细胞计数（WBC）是公认的炎症标志物。一些研究表明，这些标志物也与某些癌症有关。本研究旨在调查这些标志物在终末期癌症患者中是否出现异常，并评估它们与感染及预后的相关性。该研究强调了炎症标志物作为终末期癌症预后指标的潜力，提出对这些标志物进行常规监测可显著加强患者管理并改善预后。对116例癌症患者的病历进行了回顾性分析。收集终末期癌症患者在死亡前一周的数据。对照组由体力状况评分为3至4分、临床分期为III至IV期的癌症患者组成。呈正态分布的连续数据（均值±标准差）采用t检验进行分析。非正态分布数据（中位数[M]及四分位间距[P25，P75]）采用Wilcoxon秩和检验进行分析。数值数据采用卡方检验。采用逻辑回归分析评估炎症标志物与患者预后之间的相关性。两组在PCT、WBC、CRP、血小板计数和体重指数方面存在显著差异。然而，亚组分析表明，在死亡组中，感染患者与未感染患者的PCT、CRP和WBC水平无显著差异。值得注意的是，进一步的逻辑回归分析表明，PCT水平升高（比值比[OR]=7.13，95%置信区间[CI]=1.68 - 30.36，P=0.008）和WBC水平升高（OR=2.47，95% CI=1.13 - 1.13，P=0.024）最终被确定为与癌症患者预后不良相关的独立危险因素。在未感染患者的亚组分析中，单因素分析显示，PCT（OR=11.612，95% CI=1.217 - 110.776，P=0.033）和WBC（OR=3.077，95% CI=1.004 - 9.427，P=0.049）在存活组和死亡组的预后方面均有统计学显著差异。无论是否感染，终末期癌症患者PCT、WBC和CRP水平均显著升高。PCT和WBC升高与死亡风险增加相关。这些发现表明，监测终末期癌症患者的PCT和WBC水平可能提供有价值的预后信息，有助于临床决策。
