calca-protein--human and Liver-Neoplasms

Trans-arterial chemoembolisation (TACE) became the treatment of choice for multinodular hepatocellular carcinoma. The use of prophylactic antibiotics following intervention is controversial. This study aimed to assess the role of serum procalcitonin level in early diagnosis of bacterial infection following TACE to optimise antibiotic intake in those patients.. This study was carried on HCC patients diagnosed according to AASLD who underwent TACE and developed post interventional fever within 48 h. Laboratory investigations including CBC, neutrophil count, C-reactive protein and ESR (pre and after intervention) were done. Cultures were done according to the suspected site of infection. Serum procalcitonin was done for all the included patients before and after TACE.. Forty two TACE treated patients were included with post interventional fever within 48 h. Their ages ranged between 45 and 65 (mean 53.83 ± 5.23). All patients received antibiotic prophylaxis started 24h pre intervention and for 5 days after according to the local protocol. Five patients (11.9%) had positive blood cultures post intervention. The analysis of laboratory results showed statistical significant correlation between procalcitonin levels and positive cultures, post interventional CRP and TLC and pre interventional INR and bilirubin, while there was statistical significant correlation between CRP and post interventional temperature, total leucocytic count and site of focal lesion.. Procalcitonin seems to be a promising marker for diagnosis of sepsis in TACE treated HCC patients to optimise the unnecessary use of antibiotics.

Topics: Aged; Antibiotic Prophylaxis; Bacterial Infections; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Carcinoma, Hepatocellular; Chemoembolization, Therapeutic; Cohort Studies; Doxorubicin; Female; Follow-Up Studies; Humans; Infusions, Intra-Arterial; Liver Neoplasms; Male; Middle Aged; Prospective Studies; Protein Precursors; ROC Curve; Role; Statistics, Nonparametric; Treatment Outcome

Procalcitonin (PCT) is widely used for the diagnosis of bacterial infections. The aim of this study was to evaluate PCT as a tumor and as a prognostic marker in patients with primary lung cancer.. We retrospectively performed a PCT dosage in the frozen serum samples of 147 patients with pulmonary neoplasia for whom a test of neuron-specific enolase (NSE) had been conducted at the time of diagnosis.. We show that a PCT serum level above 0.15 ng/mL was independently linked to the presence of a neuroendocrine component in the tumor (HR=5.809 95% CI [1.695-19.908] p: 0005). Thus, median PCT serum levels were significantly more elevated in small-cell lung cancers than in pulmonary adenocarcinomas: 0.33 ng/mL versus 0.07 ng/mL (p<0.001). However, the diagnostic value of serum PCT levels for diagnosing carcinoma with a neuroendocrine component remains low (sensitivity 63.8%; specificity 71.9%). In this series, serum PCT levels were significantly more elevated in the presence of liver metastases: 0.37 ng/mL versus 0.09 ng/mL in the absence of liver metastasis (p<0.001). In uni- and multivariate analyses, a serum PCT level above 0.15n g/mL and the presence of metastases and of sepsis at the time of diagnosis were independent factors of unfavorable prognosis.. Serum PCT is elevated in patients with lung cancer with neuroendocrine component or with liver metastases. As a consequence, in this population, PCT has a poor specificity for bacterial infection. At diagnosis, an elevated serum PCT is an independent predictive factor of bad prognosis.

Topics: Adenocarcinoma; Aged; Biomarkers, Tumor; Calcitonin; Calcitonin Gene-Related Peptide; Diagnosis, Differential; Female; Humans; Kaplan-Meier Estimate; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Multivariate Analysis; Neuroendocrine Tumors; Prognosis; Protein Precursors; Retrospective Studies; Sensitivity and Specificity; Small Cell Lung Carcinoma

Procalcitonin (PCT) and interleukin-6 (IL-6) are established markers of tissue inflammation and injury. The aim of the present study was to investigate the possible correlation of PCT and IL-6 with liver metastasis.. The study consisted of fifteen healthy controls (group A), twenty-one patients with solid tumors without metastases (group B), eleven patients with liver metastasis only (group C) and eleven patients with generalized metastatic disease (group D).. Serum PCT levels were significantly increased in group D compared to groups A (p<0.001) and B (p=0.004), but no difference was observed in PCT levels between groups C and B or C and D. IL-6 serum levels were markedly elevated in group C compared to group A (p<0.001) or to groups B (p<0.001) and D (p=0.02). A positive correlation was observed between PCT and IL-6 serum levels (r=0.357, p=0.019).. PCT levels are related to disease stage in cancer patients, whereas IL-6 concentration seems to be a more specific marker of liver metastasis.

Topics: Aged; Analysis of Variance; Biomarkers, Tumor; Calcitonin; Calcitonin Gene-Related Peptide; Female; Humans; Interleukin-6; Liver Neoplasms; Male; Middle Aged; Protein Precursors

Neopterin is elevated in infections, autoimmune diseases and post-transplant. Recently neopterin elevation was linked to stress response and malignancy. To determine early changes of serum neopterin caused by surgical stress and to investigate their association with other inflammatory markers and with malignancy, we measured neopterin, C-reactive protein (CRP) and procalcitonin (PCT) levels at four predefined time-points within 24 hours in 27 patients admitted for liver resection. Our results show that neopterin increased during operation and the increase was not related to preoperative neopterin levels. On the first day after surgery neopterin level was not significantly different from postoperative levels. In patients with malignant disease neopterin concentration before operation was higher than in patients with non-malignant disease, however, the increase in neopterin concentration during operation was not different between both patient groups. During surgery CRP and PCT did not increase significantly. On the first postoperative day CRP and PCT were elevated and their levels correlated with neopterin (Pearson's correlation coefficient r=0.51 and r=0.76, respectively). We conclude that neopterin elevation during liver resection contributes major part to the increased levels observed on the first postoperative day. Perioperative neopterin release can/may be related to stress response and hypoxia produced during operation. Using this marker, hypoxic reperfusion damage could be detected earlier and more accurately.

Topics: Adolescent; Adult; Aged; Biomarkers; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Child; Child, Preschool; Female; Humans; Hypoxia; Liver; Liver Neoplasms; Male; Middle Aged; Neopterin; Prospective Studies; Protein Precursors; Reperfusion Injury; Surgical Procedures, Operative