摘要
目的评估降钙素原（PGT）检测在鉴别恶性肿瘤患者感染与肿瘤热中的价值。方法采用病例对照研究，回顾性分析2014年12月至2015年12月于安徽医科大学第一附属医院检测PCT的139例（173例次）肿瘤患者的病例资料，比较不同临床特征肿瘤患者的血清PCT水平；按患者是否发热及感染分为感染伴发热组（64例次）、感染不伴发热组（44例次）、肿瘤热组（36例次）及无感染及发热组（29例次），比较4组患者的PCT水平；用受试者操作特征曲线（ROC）评价PCT鉴别肿瘤患者感染与肿瘤热的价值。结果不同肿瘤类型及转移情况的感染患者中，PCT水平差异有统计学意义（χ^2=11．238、12．658，P=0．047、0．005），非感染患者中差异同样有统计学意义（χ^2=12．374、9．942，P：0．015、0．019）。感染伴发热组、感染不伴发热组、肿瘤热组和无感染及发热组患者的PCT水平分别为0．449（0．148，2．090）μg/L、0．107（0．056，0．441）μg/L、0．254（0．100，0．530）斗g／L和0．058（0．043，0．124）μg/L。肿瘤热组PCT水平与感染不伴发热组及血培养阴性的感染伴发热组[0．308（0．102，0．600）μg/L]比较，差异均无统计学意义（Z=-1．480、-0．965，P=0．139、0．334）。根据ROC曲线，PCT浓度以0．955μg/L为临界值，鉴别感染性发热及肿瘤热灵敏度为0．34，特异度为0．94。结论不同肿瘤类型及转移情况可影响肿瘤患者PCT水平，当发生肿瘤热时血清PCT水平可升高，并影响其诊断感染的价值。
Objective To assess the value of serum procalcitonin （PCT） level in the differentiation between infections and tumor-related fever in patients with malignant tumors. Methods Serum levels of PCT and related indicators were measured in 139 patients （ 173 times） with malignant tumors admitted in the First Affiliated Hospital of Anhui Medical University from December 2014 to December 2015. There were 64 cases of infection with fever, 44 cases of infection without fever, 36 cases of tumor-related fever and 29 non- infection, non-fever cases. Serum PCT levels of patients in 4 groups were compared by non-parametric test, and the value of PCT in the differentiation of infections and tumor-related fever was assessed by receiver operating characteristic （ROC） curve. Results There were significant differences in serum PCT levels among patients with different type of tumors （ χ^2 = 11. 238, P = 0. 047 ） and between patients with metastases and without metastases （χ^2 = 12. 658, P = 0. 005 ） in infected patients, as well as in non-infected patients （χ^2 = 12. 374,9. 942, P = 0. 015, 0. 019; respectively）. The PCT levels of infection with fever group, infection without fever group, tumor-related fever group and non-infection, non-fever group were 0. 449 （0. 148,2. 090）μg/L, 0. 107 （ 0. 056, O. 441 ） μg/L, 0. 254 （ 0. 100, 0. 530 ） μg/L and 0. 058 （ 0. 043, 0. 124）μg/L, respectively. There was no significant difference in PCT levels between tumor-related fever group and infection without fever group （Z = - 1. 480, P = 0. 139 ） , between tumor-related fever group and blood culture negative infection with fever group （Z = -0. 965, P = 0. 334）. According to the ROC, the cut- off value for PCT was defined at 0. 955 μg/L, the sensitivity and specificity of PCT in differentiation between infection and tumor-related fever was 0. 34 and 0. 94, respectively. Conclusion Tumor types and metastasis can affect serum PCT level, and PCT level can be increased in tumor-related fever, which would affect value of PCT in diagnosis of infection in tumor patients.
作者
张娜
孙耕耘
Zhang Na;Sun Gengyun(Department of Respiratory Medicine,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui,China)
出处
《中华全科医师杂志》
2018年第9期709-713,共5页
Chinese Journal of General Practitioners
基金
国家临床重点专科建设项目基金（2012.649）
关键词
肿瘤
感染
降钙素原
肿瘤热
Neoplasms
Infection
Procalcitonin
Tumor-related fever
