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Zungu PN, Mthiyane DMN, Mazibuko-Mbeje SE, Ogwuegbu MC. Dietary supplementation of low levels of unprocessed Mucuna pruriens utilis seed meal induces mild antinutritional entero-physio-metabolic perturbations without compromising performance and meat quality in finisher broilers. Trop Anim Health Prod 2023; 55:336. [PMID: 37770670 PMCID: PMC10539458 DOI: 10.1007/s11250-023-03760-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/12/2023] [Indexed: 09/30/2023]
Abstract
The rapidly growing world human population accentuates the need for improved production especially of protein-rich food. Broiler meat production offers opportunity to ensure security of this food. However, the production of modern broilers is not only limited by high feed costs due to dietary use of expensive energy and protein sources but also their meat possesses undesirable quality attributes. This study thus examined the effect of dietary Mucuna pruriens utilis seed meal (MSM) on growth performance, blood profile, carcass traits, and meat quality in finisher broiler chickens. In a completely randomised design (CRD), 320 21-day-old chicks were randomly allocated to 32 pens in which they were allotted 4 dietary treatments with 0, 2.5, 5, and 10% MSM, each with 8 replicate pens of 10 birds, for 28 days. Growth performance, carcass characteristics, internal organs, haemato-biochemistry, and meat quality were measured. Results showed that dietary MSM did not affect (P > 0.05) broiler performance, weights, and lengths of carcass cuts and internal organs, haematology, and meat quality. The only exception was MSM-induced increase in duodenal weight (linear, P < 0.05) and serum phosphorus (quadratic, P = 0.05) in contrast to a decrease in procalcitonin (quadratic, P < 0.01) and serum levels of total protein (linear, P < 0.05; and quadratic, P < 0.01), albumin (quadratic, P < 0.05), and bilirubin (quadratic, P = 0.001). Therefore, MSM could be supplemented up to 10% without compromising performance, carcass traits, internal organs, haemato-biochemistry, and meat quality in finisher broiler diets.
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Affiliation(s)
- Pretty Ntombizethu Zungu
- Department of Animal Science, School of Agricultural Sciences, Faculty of Natural and Agricultural Sciences, North-West University (Mahikeng Campus), Private Bag X 2046, Mmabatho, 2735 South Africa
| | - Doctor Mziwenkosi Nhlanhla Mthiyane
- Department of Animal Science, School of Agricultural Sciences, Faculty of Natural and Agricultural Sciences, North-West University (Mahikeng Campus), Private Bag X 2046, Mmabatho, 2735 South Africa
- Food Security and Safety Focus Area, Faculty of Natural and Agricultural Sciences, North-West University (Mahikeng Campus), Mmabatho, 2735 South Africa
| | - Sithandiwe Eunice Mazibuko-Mbeje
- Department of Biochemistry, North-West University, Mmabatho, 2745 South Africa
- Department of Life and Environmental Sciences, Polytechnic University of Marche, 60131 Ancona, Italy
| | - Mercy Chisara Ogwuegbu
- Food Security and Safety Focus Area, Faculty of Natural and Agricultural Sciences, North-West University (Mahikeng Campus), Mmabatho, 2735 South Africa
- Department of Animal Science, Faculty of Agriculture, University of Nigeria, Nsukka, Enugu State 410001 Nigeria
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Tiutan T, Wallins JS, Brown S, Gonen M, Korenstein D. Prognostic value of procalcitonin in cancer patients with coronavirus disease 2019. Clin Chem Lab Med 2023; 61:339-348. [PMID: 36367353 PMCID: PMC9747503 DOI: 10.1515/cclm-2022-0366] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 10/21/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Many biomarkers have been studied to assist in the risk stratification and prognostication of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Procalcitonin (PCT), a circulating precursor of the hormone calcitonin, has been studied with mixed results as a predictor of severe coronavirus disease 2019 (COVID-19) in the general population; however, to date, no studies have focused on the utility of PCT in predicting disease severity and death from COVID-19 in the cancer population. METHODS We conducted a retrospective study of cancer patients hospitalized with COVID-19 at a comprehensive cancer center over a 10-month period who had PCT recorded on admission. We assessed associations between variables of clinical interest and the primary outcomes of progression of COVID-19 and death during or within 30 days of hospitalization using univariable and multivariable logistic regression. RESULTS The study included 209 unique patients. In the univariate analysis, elevated PCT on admission was associated with higher odds of progression of COVID-19 or death (Odds ratio [OR] 1.40, 95% CI 1.08-1.93) and mortality alone (OR 1.53, 95% CI 1.17-2.11). In multivariate regression, PCT remained significantly associated with progression or death after holding chronic kidney disease (CKD) status constant (OR 1.40, 95% CI: 1.08, 1.93, p=0.003). Similarly, the association of PCT and death remained significant after adjusting for age (OR 1.54, 95% CI: 1.17-2.15). CONCLUSIONS In hospitalized COVID-19 patients with underlying cancer, initial PCT levels on admission may be associated with prognosis, involving higher odds of progression of COVID-19 and/or mortality.
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Affiliation(s)
- Timothy Tiutan
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Samantha Brown
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mithat Gonen
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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3
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The utility of procalcitonin for diagnosing bacteremia and bacterial pneumonia in hospitalized oncology patients. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04419-x. [DOI: 10.1007/s00432-022-04419-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/13/2022] [Indexed: 11/15/2022]
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Sabır YA, Çift T, Karaşin SS. Determining the relationship between serum acute phase reactants and cervical premalignant lesions: a cohort study. SAO PAULO MED J 2022; 141:S1516-31802022005023217. [PMID: 36794669 PMCID: PMC10065111 DOI: 10.1590/1516-3180.2022.0186.29042022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 03/28/2022] [Accepted: 04/29/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Acute phase reactants play a role in the progression and prognosis of many malignant and premalignant tumors. This study investigated the diagnostic value of certain reactants as markers for cervical premalignant lesions. OBJECTIVE Despite advanced screening and vaccination programs, cervical cancer remains a serious health problem worldwide. We aimed to determine the possible relationship between premalignant cervical disease and serum acute phase reactant levels. DESIGN AND SETTING This study included 124 volunteers who underwent cervical cancer screening. We divided the patients into three groups according to cervical cytology and histopathological findings as follows: no cervical lesion, low-grade neoplasia, or high-grade neoplasia. METHODS We included women aged 25-65 years with benign smear or colposcopy results, low- and high-grade squamous intraepithelial lesions. The benign group was based only on cytology findings, whereas the other groups were based on histopathology findings. Demographic data and serum albumin, fibrinogen, ferritin, and procalcitonin levels were evaluated in the three groups. RESULTS We found significant differences among the three groups in terms of age, albumin level, albumin/fibrinogen ratio, and procalcitonin level. The regression analysis revealed lower serum albumin levels in the low- and high-grade squamous intraepithelial lesion groups compared with the benign group. CONCLUSION This is the first study to evaluate the importance of serum inflammatory markers in cervical intraepithelial lesions. Our results indicate that serum albumin level, albumin/fibrinogen ratio, procalcitonin level, and neutrophil values differ among cervical intraepithelial lesions.
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Affiliation(s)
- Yeliz Acar Sabır
- MD. Physician, Department of Obstetrics and Gynecology, University
of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital, Bursa,
Turkey
| | - Tayfur Çift
- MD. Physician, Department of Obstetrics and Gynecology, Health
Sciences University Bursa Yüksek İhtisas Training and Research Hospital, Bursa,
Turkey
| | - Süleyman Serkan Karaşin
- MD. Physician, Department of Obstetrics and Gynecology, University
of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital, Bursa,
Turkey
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5
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The ability of inflammatory markers to recognize infection in cancer patients with fever at admission. Immunol Res 2022; 70:667-677. [PMID: 35764901 DOI: 10.1007/s12026-022-09299-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/23/2022] [Indexed: 11/05/2022]
Abstract
Infection is one of the main causes of death in cancer patients. Accurate identification of fever caused by infection could avoid unnecessary antibiotic treatment and hospitalization. This study evaluated the diagnostic value of procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), and other commonly used inflammatory markers in suspected infected adult cancer patients with fever, for better use of antibiotics. This research retrospective analyzed the clinical data of 102 adult cancer patients with fever and compared the serum levels of commonly used inflammatory markers for different fever reasons. Receiver-operating characteristic (ROC) curve and logistic regression analyses were performed. In adult cancer patients with fever, the serum PCT, CRP, IL-6, and IL-10 levels of infected patients were significantly higher than uninfected patients (median 1.19 ng/ml vs 0.14 ng/ml, 93.11 mg/l vs 56.55 mg/l, 123.74 pg/ml vs 47.35 pg/ml, 8.74 pg/ml vs 3.22 pg/ml; Mann-Whitney p = 0.000, p = 0.009, p = 0.004, p = 0.000, respectively). The ROC area under the curve(AUC) was 0.769 (95% confidence interval (CI) 0.681-0.857; p = 0.000) for PCT, 0.664 (95% CI 0.554-0.775; p = 0.009) for CRP, 0.681(95% CI 0.576-0.785; p = 0.004) for IL-6, and 0.731(95% CI 0.627-0.834; p = 0.000) for IL-10. PCT had specificity of 96.67% and positive predictive value (PPV) of 97.6%, when the cut-off value is set as 0.69 ng/ml. The serum IL-6 and IL-10 levels also had significant differences between the infected and uninfected cancer patients with advanced disease (median 128.92 pg/ml vs 36.40 pg/ml, 8.05 pg/ml vs 2.92 pg/ml; Mann-Whitney p = 0.003, p = 0.001, respectively). For the patients with neutropenia, IL-6 and IL-10 had higher AUC of 0.811 and 0.928, respectively. With a cut-off of 9.10 pg/ml, IL-10 had the highest sensitivity 83.33% and specificity 100%. In adult cancer patients, PCT had the best performance compared to CRP, IL-6, and IL-10 in differentiating infected from uninfected causes of fever, with high specificity and PPV. IL-6 and IL-10 might be useful in cancer patients with severe bloodstream infections and advanced disease. However, for patients with neutropenia, IL-10 might be more valuable than PCT in diagnosing infection.
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Effendi B, Pitoyo CW, Sinto R, Suwarto S. Procalcitonin prognostic value in predicting mortality among adult patients with sepsis due to Gram-negative bacteria. MEDICAL JOURNAL OF INDONESIA 2022. [DOI: 10.13181/mji.oa.225864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Sepsis is a leading cause of mortality and morbidity globally. Gram-negative bacteremia was reported to have a high risk of septic shock and poor prognosis. This study aimed to evaluate the role of procalcitonin in predicting mortality in patients with sepsis due to Gram-negative bacteria.
METHODS This was a retrospective cohort study performed based on medical records and sepsis registry of Tropical and Infectious Disease Division, Department of Internal Medicine, Cipto Mangunkusumo Hospital. The inclusion criteria were patients aged ≥18 years diagnosed with sepsis due to Gram-negative bacteria based on blood culture on admission and hospitalized between March 2017 and October 2020. Data taken from medical records included subjects’ characteristics, laboratory parameters, and 28-day mortality outcomes during hospitalization. Receiver operating characteristic was used to determine the area under the curve (AUC) of procalcitonin and its accuracy.
RESULTS A total of 128 patients were eligible. The cumulative survival of patients with Gram-negative bacteremia was 48.4% (standard error 0.96%). The AUC of procalcitonin to predict mortality was 0.45 (95% confidence interval 0.36–0.54). Escherichia coli was the predominant microorganism in blood culture (n = 38, 29.7%).
CONCLUSIONS Procalcitonin has a poor performance in predicting mortality of patients with sepsis due to Gram-negative bacteria.
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Bacterial Translocation in Gastrointestinal Cancers and Cancer Treatment. Biomedicines 2022; 10:biomedicines10020380. [PMID: 35203589 PMCID: PMC8962358 DOI: 10.3390/biomedicines10020380] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 11/16/2022] Open
Abstract
In recent years, there has been increasing evidence that gut microbiota is associated with the onset and exacerbation of various diseases, such as gastrointestinal cancer. For instance, it is well known that local inflammation of the intestinal tract in colorectal cancer that is caused by the increased number of Fusobacterium, due to changes in the intestinal bacterial flora, is involved in carcinogenesis. In contrast, gut bacteria or their products, pathogen-associated molecular patterns, not only cause intestinal inflammation but also invade the bloodstream through dysbiosis and gut barrier dysfunction, thereby leading to systemic inflammation, namely bacterial translocation. The involvement of bacterial translocation in the carcinogenesis of gastrointestinal cancers and their prognosis is increasingly being recognized. The Toll-like receptor signaling pathways plays an important role in the carcinogenesis of such cancers. In addition, bacterial translocation influences the treatment of cancers such as surgery and chemotherapy. In this review, we outline the concept of bacterial translocation, summarize the current knowledge on the relationship between gut bacteria and gastrointestinal cancer, and provide future perspectives of this field.
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8
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Yan Y, Chen C, Liu Y, Zhang Z, Xu L, Pu K. Application of Machine Learning for the Prediction of Etiological Types of Classic Fever of Unknown Origin. Front Public Health 2022; 9:800549. [PMID: 35004599 PMCID: PMC8739804 DOI: 10.3389/fpubh.2021.800549] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/08/2021] [Indexed: 12/22/2022] Open
Abstract
Background: The etiology of fever of unknown origin (FUO) is complex and remains a major challenge for clinicians. This study aims to investigate the distribution of the etiology of classic FUO and the differences in clinical indicators in patients with different etiologies of classic FUO and to establish a machine learning (ML) model based on clinical data. Methods: The clinical data and final diagnosis results of 527 patients with classic FUO admitted to 7 medical institutions in Chongqing from January 2012 to August 2021 and who met the classic FUO diagnostic criteria were collected. Three hundred seventy-three patients with final diagnosis were divided into 4 groups according to 4 different etiological types of classical FUO, and statistical analysis was carried out to screen out the indicators with statistical differences under different etiological types. On the basis of these indicators, five kinds of ML models, i.e., random forest (RF), support vector machine (SVM), Light Gradient Boosting Machine (LightGBM), artificial neural network (ANN), and naive Bayes (NB) models, were used to evaluate all datasets using 5-fold cross-validation, and the performance of the models were evaluated using micro-F1 scores. Results: The 373 patients were divided into the infectious disease group (n = 277), non-infectious inflammatory disease group (n = 51), neoplastic disease group (n = 31), and other diseases group (n = 14) according to 4 different etiological types. Another 154 patients were classified as undetermined group because the cause of fever was still unclear at discharge. There were significant differences in gender, age, and 18 other indicators among the four groups of patients with classic FUO with different etiological types (P < 0.05). The micro-F1 score for LightGBM was 75.8%, which was higher than that for the other four ML models, and the LightGBM prediction model had the best performance. Conclusions: Infectious diseases are still the main etiological type of classic FUO. Based on 18 statistically significant clinical indicators such as gender and age, we constructed and evaluated five ML models. LightGBM model has a good effect on predicting the etiological type of classic FUO, which will play a good auxiliary decision-making function.
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Affiliation(s)
- Yongjie Yan
- School of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Chongyuan Chen
- Key Laboratory of Data Engineering and Visual Computing, Chongqing University of Posts and Telecommunications, Chongqing, China
| | - Yunyu Liu
- Medical Records and Statistics Office, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zuyue Zhang
- School of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Lin Xu
- School of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Kexue Pu
- School of Medical Informatics, Chongqing Medical University, Chongqing, China
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Huang X, Chen Y, Shi X. Laparoscopic hepatectomy versus open hepatectomy for tumors located in right posterior segment: A single institution study. Asian J Surg 2021; 45:110-116. [PMID: 33863627 DOI: 10.1016/j.asjsur.2021.03.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/04/2021] [Accepted: 03/24/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECT With the gradual advancement of laparoscopic technology, surgeries can be successfully performed with the help of laparoscopy increasingly. This study initially explored the difference between laparoscopic right posterior sectionectomy (LRPS) and open right posterior sectionectomy (ORPS)of liver in our center, discussed the effectiveness, benefits and safety of LRPS and introduce some surgical techniques in our center. MATERIALS AND METHODS We retrospectively analyze 96 cases of liver tumor located in the right posterior lobe of liver in our institution from January 2015 to January 2018. There were 46 cases performed the LRPS surgery and 50 cases performed the ORPS surgery. Through analysis of the perioperative outcomes of these two groups by a case control study, we compare the differences between these two groups. RESULTS There was no significant difference between the LRPS and ORPS group in demographic and baseline characteristics before surgery. Patients in the LRPS group were significantly superior to ORPS in terms of postoperative liver function recovery, postoperative inflammatory factor level, pain sensation (3.03 ± 0.79 vs 4.58 ± 1.25), abdominal incision length (6.25 ± 2.34 vs 32.15 ± 3.21), carrying abdominal drainage tube time (3.26 ± 0.77 vs 4.83 ± 0.76), recovery of bowel function time (1.6 ± 0.61 VS 3.05 ± 0.85)and postoperative hospital stay (5.73 ± 0.99 vs 7.16 ± 0.95) (P < 0.05). CONCLUSION Compared with the traditional ORPS, LRPS has the advantages of minor injury, faster recovery and mild inflammatory reaction. The LRPS is safe and feasible, and it should be gradually promoted in clinical practice.
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Affiliation(s)
- Xiaodong Huang
- Faculty of Hepato-Pancreato-Biliary Surgery, 1th Medical Center, Chinese PLA General Hospital, Beijing, 100853, PR China.
| | - Yongwei Chen
- Faculty of Hepato-Pancreato-Biliary Surgery, 1th Medical Center, Chinese PLA General Hospital, Beijing, 100853, PR China.
| | - Xianjie Shi
- Faculty of Hepato-Pancreato-Biliary Surgery, 1th Medical Center, Chinese PLA General Hospital, Beijing, 100853, PR China.
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Xu L, Jin J, Wu G, Chen T, Xu D, Zhu F, Xiao S, Xia Z, Wang G. Elevated serum procalcitonin early after extensive burn: influencing factors and clinical significance. Burns 2020; 47:1399-1407. [PMID: 33934906 DOI: 10.1016/j.burns.2020.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 11/28/2020] [Accepted: 12/07/2020] [Indexed: 12/13/2022]
Abstract
The study was carried out to analyze the factors influencing the elevated serum procalcitonin (PCT) levels during the early phase of extensive burn, and to investigate its potential for sepsis prediction and prognosis. Clinical data of 324 patients with extensive burns treated at our department from July 2014 to December 2019 were retrospectively analyzed. Approximately half of the patients (50.93%) exhibited elevated serum PCT concentrations during the early phase, and elevated PCT levels may not be caused by infections. Early-phase PCT level was an independent risk factor for sepsis occurrence in extensive-burn patients within 60 days of injury. Burn index, degree of inhalation injury, and APACHE-II score influenced PCT level elevation during the early phase. Patient age, burn index, APACHE-II score at admission, early-phase PCT level, and sepsis occurrence were risk factors for mortality in extensive-burn patients. During the early phase, approximately 50.93% of the extensive-burn patients exhibited elevated PCT levels, which were associated with non-infectious factors. As elevated PCT level during the early phase predicted sepsis occurrence within 60 days of injury and was significantly associated with patient mortality, it might be a potential burn severity indicator during the early phase of burn injury.
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Affiliation(s)
- Long Xu
- Center of Burns and Trauma, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai 200433, PR China
| | - Jian Jin
- Center of Burns and Trauma, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai 200433, PR China
| | - Guosheng Wu
- Center of Burns and Trauma, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai 200433, PR China
| | - Tiansheng Chen
- Center of Burns and Trauma, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai 200433, PR China
| | - Dayuan Xu
- Center of Burns and Trauma, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai 200433, PR China
| | - Feng Zhu
- Center of Burns and Trauma, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai 200433, PR China
| | - Shichu Xiao
- Center of Burns and Trauma, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai 200433, PR China
| | - Zhaofan Xia
- Center of Burns and Trauma, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai 200433, PR China
| | - Guangyi Wang
- Center of Burns and Trauma, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai 200433, PR China.
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Miyake T, Iida H, Shimizu T, Ueki T, Kojima M, Ohta H, Yamaguchi T, Kaida S, Mekata E, Endo Y, Tani M. The Elevation in Preoperative Procalcitonin Is Associated with a Poor Prognosis for Patients Undergoing Resection for Colorectal Cancer. Dig Surg 2020; 38:80-86. [PMID: 33242873 DOI: 10.1159/000511908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/22/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Procalcitonin (PCT) is a well-known marker for bacterial infection; however, the clinical significance of PCT in the long-term prognosis after colorectal cancer (CRC) surgery remains unclear. METHODS This is a retrospective review of 277 patients that underwent CRC surgery to investigate the relationship between preoperative PCT, clinicopathological condition, cancer-specific overall survival (OS), and relapse-free survival (RFS). RESULTS Median follow-up interval was 5.0 years in all patients. Thirty-six patients developed recurrence, and 46 patients died due to recurrences or metastases of CRC. Preoperative PCT levels were highest in Stage IV patients. The cancer-specific OS in patients with Stage IV/PCT ≤0.05 ng/mL was significantly higher than those with Stage IV/PCT >0.05 ng/mL (3 years survival; 42.3 vs. 14.3%, p = 0.0413). On multivariate analysis, gender, TNM classification, and PCT were identified as significant risk factors for cancer-specific OS in patients with Stage I-III CRC. The cancer-specific OS rate of these patients with PCT ≥0.08 ng/mL, compared with PCT <0.08 ng/mL, was significantly decreased (5 years survival; 59.1 vs. 92.7%, p < 0.0001). TNM classification was finally identified as an independent risk factor for cancer-specific RFS in these patients by multivariate analysis. CONCLUSION High preoperative PCT values in CRC patients appeared to be associated with poor OS but not RFS following surgical treatments.
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Affiliation(s)
- Toru Miyake
- Department of Surgery, Shiga University of Medical Science, Shiga, Japan
| | - Hiroya Iida
- Department of Surgery, Shiga University of Medical Science, Shiga, Japan
| | - Tomoharu Shimizu
- Medical Safety Section, Shiga University of Medical Science Hospital, Shiga, Japan,
| | - Tomoyuki Ueki
- Department of Surgery, Shiga University of Medical Science, Shiga, Japan
| | - Masatsugu Kojima
- Department of Surgery, Shiga University of Medical Science, Shiga, Japan
| | - Hiroyuki Ohta
- Department of Comprehensive Surgery, Shiga University of Medical Science, Shiga, Japan
| | - Tsuyoshi Yamaguchi
- Department of Surgery, Shiga University of Medical Science, Shiga, Japan
| | - Sachiko Kaida
- Department of Surgery, Shiga University of Medical Science, Shiga, Japan
| | - Eiji Mekata
- Department of Comprehensive Surgery, Shiga University of Medical Science, Shiga, Japan
| | - Yoshihiro Endo
- Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan
| | - Masaji Tani
- Department of Surgery, Shiga University of Medical Science, Shiga, Japan
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Diagnostic Accuracy of Procalcitonin, Neutrophil-to-Lymphocyte Ratio, and C-Reactive Protein in Detection of Bacterial Infections and Prediction of Outcome in Nonneutropenic Febrile Patients with Lung Malignancy. JOURNAL OF ONCOLOGY 2020; 2020:2192378. [PMID: 32908505 PMCID: PMC7468665 DOI: 10.1155/2020/2192378] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/15/2020] [Accepted: 08/08/2020] [Indexed: 12/17/2022]
Abstract
Background Procalcitonin (PCT), C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) have emerged as important markers of inflammation, and these markers, especially PCT and CRP, have been studied in patients with neutropenia. This study was designed to evaluate their value in differentiating infectious fever from tumor fever (TF) and to investigate their role in assessing outcomes in nonneutropenic lung cancer patients (NNLCPs). Methods This retrospective clinical study included 588 febrile NNLCPs between January 2019 and December 2019. The levels of PCT, CRP, and conventional inflammatory markers, including white blood cells (WBC) and neutrophils (NEU), were measured. NLR was defined as the ratio of the absolute neutrophil count to the absolute lymphocyte count. Patients' clinical and bacteriological data were recorded. Results This study included 311 NNLCPs with bacterial infections and 277 with TF. Inflammatory markers such as PCT, CRP, WBC, and NEU levels and NLR were significantly higher in patients with bacterial infections than in those with TF (p < 0.0001). However, PCT level was the best predictor of bacterial infections, with an area under the curve (AUC) of 0.874, followed by CRP level (AUC = 0.855) and NLR (AUC = 0.792) (p < 0.0001). Additionally, PCT level was significantly elevated in patients with bacterial infections with progressive disease after radiotherapy and chemotherapy (p < 0.01). Conclusions The present study demonstrated the superiority of PCT over CRP and NLR in the diagnosis of febrile patients with bacterial infections. Additionally, PCT can be used to assess the clinical outcomes and cancer progression in NNLCPs.
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Mohamed S, Abdelhaffez A, Abd El-Aziz N. Serum Procalcitonin in Patients With Combined Lung Cancer and Idiopathic Pulmonary Fibrosis (LC-IPF). Cureus 2020; 12:e9507. [PMID: 32879828 PMCID: PMC7458704 DOI: 10.7759/cureus.9507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Procalcitonin (PCT) is a potential biomarker for sepsis and acts as a guide to antibiotic administration. Previous studies showed that lung cancer (LC) may increase serum PCT levels. However, no studies addressed serum PCT in patients with combined LC and idiopathic pulmonary fibrosis (IPF): LC-IPF. We aimed to evaluate the significance of serum PCT in patients with LC-IPF. Methods A total of 137 patients with IPF who had complete follow-up data were reviewed. They were categorized into two groups: 30 patients with LC and IPF (LC-IPF) and 82 patients with IPF only (IPF). PCT assays in the two groups were done using the enzyme-linked immunosorbent assay (ELISA) technique. Results Median serum PCT (IQR) was significantly higher in patients with LC-IPF in comparison to those with IPF only (0.655± 3.60 vs 0.07 ± 0.11 ng/ml, p=0.016), respectively. LC-IPF patients with neuroendocrine (NE) component, stage IV disease, and with >2 metastatic sites had a significantly higher PCT in comparison to those with non-NE, stages I-III, and <2 metastatic sites, respectively. The presence of the NE component was the only independent risk factor predictive for PCT positivity in patients with LC-IPF; OR1.8 (95% confidence interval (CI) 0.042-2.145; p = 0.042). Conclusion Patients with LC-IPF have higher serum PCT levels than those with IPF alone. These levels are related to the presence of NE component, advanced cancer stage, and the presence of multiple metastases. The presence of the NE component is the only independent risk factor predictive for PCT positivity in patients with LC-IPF. Further studies are warranted.
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Han X, Zhong H, Hong D, Li C, Su H, Xu K. Elevated procalcitonin levels in primary hepatic neuroendocrine carcinoma: Case report and literature review. Medicine (Baltimore) 2020; 99:e21210. [PMID: 32756098 PMCID: PMC7402732 DOI: 10.1097/md.0000000000021210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
RATIONALE Procalcitonin (PCT) has been identified as a tumor biomarker in medullary thyroid carcinoma. Other neuroendocrine carcinomas with elevated PCT levels are relatively rare, and are mainly reported in the lung, digestive tract, and pancreas. No studies in the literature have reported a case of primary hepatic carcinoma complicated with unexpectedly elevated PCT levels. PATIENT CONCERNS A 78-year-old man with persistent fatigue and mild fever was complicated with an extremely high PCT level. Radiological examination revealed a single hypodense lesion in the left lobe of the liver with a "rapid enhancement and rapid washout" pattern. Pathological analysis showed a poorly differentiated neuroendocrine carcinoma (grade 3) with multiple genetic mutations. DIAGNOSIS Primary hepatic neuroendocrine carcinoma. INTERVENTIONS The patient received antibiotic therapy and subsequent transcatheter hepatic arterial chemoembolization; a PCT assessment and computed tomography were performed during the follow-up. OUTCOMES The PCT level did not decline after antibiotic therapy but greatly declined in response to effective transcatheter hepatic arterial chemoembolization. The patient survived and is still being followed up. LESSONS An extremely elevated PCT level may raise a suspicion of a neuroendocrine carcinoma and plays an indicative role as a biomarker during therapy.
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El Haddad H, Chaftari AM, Hachem R, Chaftari P, Raad II. Biomarkers of Sepsis and Bloodstream Infections: The Role of Procalcitonin and Proadrenomedullin With Emphasis in Patients With Cancer. Clin Infect Dis 2019; 67:971-977. [PMID: 29668936 DOI: 10.1093/cid/ciy331] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/12/2018] [Indexed: 12/22/2022] Open
Abstract
Sepsis and bloodstream infections remain a leading cause of death in immunocompromised patients with cancer. The management of these serious infections consist of empiric use of antimicrobial agents which are often overused. Procalcitonin and proadrenomedullin are biomarkers that have been extensively evaluated in the general populations but with little emphasis in the population immunocompromised patients with cancer, where they may have promising roles in the management of febrile patients. In this review, we summarize the available evidence of the potential role of these available biomarkers in guiding antimicrobial therapy to optimize the use of resources in the general patient population. Special emphasis is given to the role of these 2 biomarkers in the immunocompromised and critically ill patients with cancer, highlighting the distinctive utility of each.
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Affiliation(s)
- Hanine El Haddad
- Section of Infectious Diseases, Baylor College of Medicine.,Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston
| | - Anne-Marie Chaftari
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston
| | - Ray Hachem
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston
| | - Patrick Chaftari
- Department of Emergency Medicine, The University of Texas M. D. Anderson Cancer Center, Houston
| | - Issam I Raad
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston
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Soeroso NN, Tanjung MF, Afiani D, Pradana A, Tarigan SP, Wahyuni AS. Procalcitonin Level in Non-Small Cell Lung Cancer Patients among Indonesian Population. Open Access Maced J Med Sci 2018; 6:2123-2127. [PMID: 30559873 PMCID: PMC6290421 DOI: 10.3889/oamjms.2018.421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/18/2018] [Accepted: 10/21/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Serum Procalcitonin (PCT) is a biomarker that is frequently used to diagnose an infection. In some cases of thoracic malignancy, procalcitonin level appears to increase. However, the role of procalcitonin to diagnose malignancy is not certain yet, and the causes have not been known. AIM This study aimed to investigate procalcitonin levels in non-small cell lung cancer patients. METHODS This was an observational study with a cross-sectional design. All lung cancer patients did not diagnose based on cytology/histopathology results with no evidence nor were signs and symptoms of infection recruited through consecutive sampling. The subtypes of lung cancer include adenocarcinoma, squamous cell carcinoma, and large cell carcinoma, staged III and IV. The procalcitonin levels were analysed from blood using immunofluorescent assay. Data were then analysed with the Chi-Square test by Epi Info™ 7 programs in which p-value < 0.05 was considered statistically significant. RESULTS A total of 68 lung cancer patients fulfilled the criteria of this study, 55 men (80.9%) and 13 women (19.1%). The highest percentage of cytology/histopathology type found was adenocarcinoma (80.9%), and 60.3% of those were diagnosed in stage IV. An increased procalcitonin level (greater than 0.01 ng/mL) occurred in 80.9% of Non-Small Cell Lung Cancer (NSCLC) patients. It appears that the higher the stage of lung cancer, the lower procalcitonin levels would be, although it was not statistically significant. There was no association between lung cancer subtype with procalcitonin levels. CONCLUSION An increased level of procalcitonin may be an indication not only for infection but also for Non-Small Cell Lung Cancer.
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Affiliation(s)
- Noni Novisari Soeroso
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Sumatera Utara, University of Sumatera Utara Hospital, Jl. Dr. Mansyur No.66 Medan 20154, Sumatera Utara, Indonesia
| | - Muhammad Faiz Tanjung
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Sumatera Utara, University of Sumatera Utara Hospital, Jl. Dr. Mansyur No.66 Medan 20154, Sumatera Utara, Indonesia
| | - Dina Afiani
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Sumatera Utara, University of Sumatera Utara Hospital, Jl. Dr. Mansyur No.66 Medan 20154, Sumatera Utara, Indonesia
| | - Andika Pradana
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Sumatera Utara, University of Sumatera Utara Hospital, Jl. Dr. Mansyur No.66 Medan 20154, Sumatera Utara, Indonesia
| | - Setia Putra Tarigan
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Sumatera Utara, University of Sumatera Utara Hospital, Jl. Dr. Mansyur No.66 Medan 20154, Sumatera Utara, Indonesia
| | - Arlinda Sari Wahyuni
- Department of Public Health, Faculty of Medicine, University of Sumatera Utara, Jl. Dr. Mansyur No.66 Medan 20154, Sumatera Utara, Indonesia
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Zhao Z, Li X, Zhao Y, Wang D, Li Y, Liu L, Sun T, Chen G. Role of C-reactive protein and procalcitonin in discriminating between infectious fever and tumor fever in non-neutropenic lung cancer patients. Medicine (Baltimore) 2018; 97:e11930. [PMID: 30113495 PMCID: PMC6112972 DOI: 10.1097/md.0000000000011930] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This study assessed whether C-reactive protein (CRP) and procalcitonin (PCT) levels can discriminate between infectious fever and tumor fever (TF) in non-neutropenic patients with nonsmall cell lung cancer (NSCLC).This retrospective clinical study included 96 adults with NSCLC who were admitted to the Third Hospital of Hebei Medical University between July 2015 and July 2017. Febrile, non-neutropenic patients were enrolled. CRP and PCT levels, neutrophil count, and antimicrobial response were evaluated.This study included 26 patients with TF, 49 with localized bacterial infection (LBI), and 21 with bloodstream infection (BSI). CRP levels in BSI were significantly higher than in TF (P < .05) and LBI (P < .05). No statistically significant difference was found between patients with TF and LBI (P > .05). PCT levels were significantly higher in BSI and LBI than in TF (P < .05). CRP and PCT levels in patients with stage IV disease were significantly higher than in those with stage II to III disease (P < .05). CRP and PCT levels declined significantly in patients with BSI who were responding to antimicrobials (P < .05).Compared with CRP levels, PCT levels can discriminate between TF and infectious fever more accurately. PCT and CRP levels may predict different stages of lung cancer.
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Affiliation(s)
- Zhifang Zhao
- Department of Respiration, The Third Hospital of Hebei Medical University
| | - Xuze Li
- Department of Anesthesiology, The Second Hospital of Hebei Medical University
| | - Yunxia Zhao
- Department of Respiration, The Third Hospital of Hebei Medical University
| | - Dongchang Wang
- Department of Respiration, The Third Hospital of Hebei Medical University
| | - Yahua Li
- Department of Respiration, The Third Hospital of Hebei Medical University
| | - Le Liu
- Department of Respiration, The Third Hospital of Hebei Medical University
| | - Tao Sun
- Department of Orthopaedic Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Gang Chen
- Department of Respiration, The Third Hospital of Hebei Medical University
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Aziz SA, Nelwan EJ, Sukrisman L, Suhendro S. Higher cut-off serum procalcitonin level for sepsis diagnosis in metastatic solid tumor patients. BMC Res Notes 2018; 11:84. [PMID: 29382396 PMCID: PMC5791197 DOI: 10.1186/s13104-018-3204-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/25/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The current study aimed to know procalcitonin levels in patients with metastatic tumor, and to discover the cut-off point for sepsis in this population. A cross-sectional study was conducted with patients with solid tumor. Sepsis and systemic inflammation response syndrome (SIRS) were identified using clinical, laboratory, and microbiological criteria. The cut-off point was determined using receiver operating characteristic (ROC) curve. RESULTS A total of 112 subjects enrolled in this study, 51% male, mean age 47.9 ± 12.47 years. Among 71 (63.4%) patients who had metastasis, 36 (32.1%) had sepsis and 6 (5.3%) experienced SIRS. In the absence of sepsis, the procalcitonin levels were significantly higher in patients with metastatic tumor compared to those without [0.25 ng/mL (0.07-1.76) vs. 0.09 ng/mL (0.03-0.54); p < 0.001]. The ROC curve showed that levels of procalcitonin for sepsis in metastatic solid tumors were in the area under curve (AUC) [0.956; CI 0.916-0.996]. Cut-off point of procalcitonin for sepsis was 1.14 ng/mL, Sn 86%, and Sp 88%. Thus, the results show that metastatic tumor affects the patients' procalcitonin level, even in the absence of sepsis. The cut-off point of procalcitonin level for diagnosing sepsis in the meta-static solid tumor was higher compared to the standard value.
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Affiliation(s)
- Segal Abdul Aziz
- Department of Internal Medicine, Medical Faculty University of Indonesia-Cipto Mangunkusumo General Hospital, Jalan Diponegoro No. 71, Jakarta, 10430, Indonesia.
| | - Erni Juwita Nelwan
- Division of Tropical Medicine and Infectious Disease, Department of Internal Medicine, Medical Faculty University of Indonesia-Cipto Mangunkusumo General Hospital, Jalan Diponegoro No. 71, Jakarta, 10430, Indonesia
| | - Lugyanti Sukrisman
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Medical Faculty University of Indonesia-Cipto Mangunkusumo General Hospital, Jalan Diponegoro No. 71, Jakarta, 10430, Indonesia
| | - Suhendro Suhendro
- Division of Tropical Medicine and Infectious Disease, Department of Internal Medicine, Medical Faculty University of Indonesia-Cipto Mangunkusumo General Hospital, Jalan Diponegoro No. 71, Jakarta, 10430, Indonesia
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Chen L, Zhang Y, Lin Y, Deng L, Feng S, Chen M, Chen J. The role of elevated serum procalcitonin in neuroendocrine neoplasms of digestive system. Clin Biochem 2017; 50:982-987. [PMID: 28668469 DOI: 10.1016/j.clinbiochem.2017.06.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 06/08/2017] [Accepted: 06/26/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Elevated serum procalcitonin (PCT) was reported in patients with certain type of neuroendocrine neoplasms (NENs). OBJECTIVE The aim of this study was to assess the role of elevated serum PCT in NENs from digestive system. PATIENTS AND METHODS Serum PCT and serum CgA level were measured in 155 patients with NENs from digestive system. RESULTS Elevated serum PCT was found in 63 patients (40.6%). Grade 3 disease was a significant factor associated with elevated serum PCT (OR, 9.24; 95%CI, 3.04-28.08; P<0.001). Serum PCT level was significantly decreased after treatment both in patients with stable disease (P=0.003) and patients with partial remission (P=0.001). In these patients, serum PCT level significantly increased again at the time of progression disease (P=0.001). Elevated serum PCT was a significant factor of worse survival (HR, 2.86; 95%CI, 1.36-6.03; P=0.006). Compared with patients with normal serum PCT and CgA level, patients with either PCT or CgA elevated and patients with both PCT and CgA elevated had progressively worse survival. Additionally, PCT expression in tumor cells was found in 24.0% of patients but did not correlate with other clinicopathological factors, including serum PCT. CONCLUSIONS Serum PCT is elevated in part of patients with NENs of digestive system, especially in patients with grade 3 disease. Serum PCT level can help evaluate treatment response and its elevation indicates poor prognosis. Combination of serum PCT and CgA can improve outcome prediction.
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Affiliation(s)
- Luohai Chen
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou, China, 510080
| | - Yu Zhang
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou, China, 510080.
| | - Yuan Lin
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou, China, 510080.
| | - Langhui Deng
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou, China, 510080.
| | - Shiting Feng
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou, China, 510080.
| | - Minhu Chen
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou, China, 510080.
| | - Jie Chen
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou, China, 510080.
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Procalcitonin is a Poor Predictor of Non-Infectious Fever in the Neurocritical Care Unit. Neurocrit Care 2017; 27:237-241. [DOI: 10.1007/s12028-016-0337-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Durnaś B, Wątek M, Wollny T, Niemirowicz K, Marzec M, Bucki R, Góźdź S. Utility of blood procalcitonin concentration in the management of cancer patients with infections. Onco Targets Ther 2016; 9:469-75. [PMID: 26858528 PMCID: PMC4731001 DOI: 10.2147/ott.s95600] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Diagnosis of infections in cancer patients is usually problematic since differentiating between infection and fever of unknown origin is often a considerable clinical challenge. In general, increase concentration of blood procalcitonin (PCT) is associated with severe bacterial infection. PCT with an optimal cutoff level of 0.5 ng/mL seems to be the most helpful biochemical parameter in detecting severe infections, mainly bloodstream infection, in patients with hematological cancers. In all clinical situations, the elevated level of PCT should be carefully analyzed, always with a thorough physical examination and an appropriate microbiological assessment.
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Affiliation(s)
- Bonita Durnaś
- Holy Cross Oncology Center of Kielce, Artwińskiego, Kielce, Poland; Department of Physiology, Pathophysiology and Microbiology of Infections, The Faculty of Health Sciences of the Jan Kochanowski University in Kielce, Aleja IX Wieków Kielc, Kielce, Poland
| | - Marzena Wątek
- Holy Cross Oncology Center of Kielce, Artwińskiego, Kielce, Poland
| | - Tomasz Wollny
- Holy Cross Oncology Center of Kielce, Artwińskiego, Kielce, Poland
| | - Katarzyna Niemirowicz
- Department of Microbiological and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok, Poland
| | - Michał Marzec
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert Bucki
- Department of Physiology, Pathophysiology and Microbiology of Infections, The Faculty of Health Sciences of the Jan Kochanowski University in Kielce, Aleja IX Wieków Kielc, Kielce, Poland; Department of Microbiological and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok, Poland
| | - Stanisław Góźdź
- Holy Cross Oncology Center of Kielce, Artwińskiego, Kielce, Poland
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Herrmann K, Schinke S, Csernok E, Moosig F, Holle JU. Diagnostic Value of Procalcitonin in ANCA-Associated Vasculitis (AAV) to Differentiate Between Disease Activity, Infection and Drug Hypersensitivity. Open Rheumatol J 2015; 9:71-6. [PMID: 26535070 PMCID: PMC4627387 DOI: 10.2174/1874312901409010071] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 07/16/2015] [Accepted: 07/23/2015] [Indexed: 11/22/2022] Open
Abstract
Objective: Procalcitonin (PCT) is considered to be a specific marker for severe bacterial infections and sepsis. Elevated PCT levels have been reported in active autoimmune diseases without infection. The aim of this study was to assess the diagnostic value of PCT serum levels in ANCA-associated vasculitis (AAV) patients with respect to infection, disease activity and drug fever using a high sensitive PCT detection method. Methods: In 53 AAV patients with elevated C-reactive protein (CRP) PCT was determined by the Thermo Scientific BRAHMS PCT sensitive KRYPTOR assay. Patients underwent standardized diagnostic procedures for evaluation of disease activity and infection. Results: 53 patients with AAV and elevated CRP (7.7±6.9 mg/dl, PCT 0.34±1.02 ng/ml) were assessed, 10 had infection with elevated CRP levels of 11.2±10.2 mg/dl and PCT levels of 1.06±2.07 ng/dl. 43 patients had no evidence of infection, 36 of them were presented with AAV with normal or only slightly positive PCT levels in active disease (n=36) (PCT 0.06±0.06 ng/ml). 7 patients had increased PCT levels due to azathioprine hypersensitivity (0.76±1.01 ng/ml). For discrimination between infection and vasculitis activity PCT was more useful than CRP with the best cut-off at 0.1 ng/ml (sensitivity 60%, specificity 92%). Conclusion: In contrast to previous studies using semiquantitative PCT assays, the KRYPTOR performs better with respect to discrimination of infection from active AAV. In all patients assessed with active AAV (and without infection) PCT levels remained below the PCT reference limit (0.5 ng/ml) for infections. Drug hypersensitivity seems to be an important differential diagnosis in the setting of elevated CRP and PCT in patients who receive azathioprine.
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Affiliation(s)
- K Herrmann
- Division of Rheumatology, Department of Medicine III, University Medical Center Carl Gustav Carus at the TU Dresden, Dresden, Germany ; Department of Rheumatology, Klinikum Bad Bramstedt, Germany
| | - S Schinke
- Department of Rheumatology, Klinikum Bad Bramstedt, Germany
| | - E Csernok
- Department of Rheumatology, Klinikum Bad Bramstedt, Germany
| | - F Moosig
- Department of Rheumatology, Klinikum Bad Bramstedt, Germany
| | - J U Holle
- Department of Rheumatology, Klinikum Bad Bramstedt, Germany
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Rule JA, Hynan LS, Attar N, Sanders C, Korzun WJ, Lee WM. Procalcitonin Identifies Cell Injury, Not Bacterial Infection, in Acute Liver Failure. PLoS One 2015; 10:e0138566. [PMID: 26393924 PMCID: PMC4579124 DOI: 10.1371/journal.pone.0138566] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 09/01/2015] [Indexed: 12/22/2022] Open
Abstract
Background Because acute liver failure (ALF) patients share many clinical features with severe sepsis and septic shock, identifying bacterial infection clinically in ALF patients is challenging. Procalcitonin (PCT) has proven to be a useful marker in detecting bacterial infection. We sought to determine whether PCT discriminated between presence and absence of infection in patients with ALF. Method Retrospective analysis of data and samples of 115 ALF patients from the United States Acute Liver Failure Study Group randomly selected from 1863 patients were classified for disease severity and ALF etiology. Twenty uninfected chronic liver disease (CLD) subjects served as controls. Results Procalcitonin concentrations in most samples were elevated, with median values for all ALF groups near or above a 2.0 ng/mL cut-off that generally indicates severe sepsis. While PCT concentrations increased somewhat with apparent liver injury severity, there were no differences in PCT levels between the pre-defined severity groups–non-SIRS and SIRS groups with no documented infections and Severe Sepsis and Septic Shock groups with documented infections, (p = 0.169). PCT values from CLD patients differed from all ALF groups (median CLD PCT value 0.104 ng/mL, (p ≤0.001)). Subjects with acetaminophen (APAP) toxicity, many without evidence of infection, demonstrated median PCT >2.0 ng/mL, regardless of SIRS features, while some culture positive subjects had PCT values <2.0 ng/mL. Summary/Conclusions While PCT appears to be a robust assay for detecting bacterial infection in the general population, there was poor discrimination between ALF patients with or without bacterial infection presumably because of the massive inflammation observed. Severe hepatocyte necrosis with inflammation results in elevated PCT levels, rendering this biomarker unreliable in the ALF setting.
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Affiliation(s)
- Jody A Rule
- Department of Internal Medicine, Division of Digestive Diseases, UT Southwestern Medical Center, Dallas, Texas, United States of America; Department of Clinical Laboratory Sciences, School of Allied Health, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Linda S Hynan
- Department of Clinical Sciences and Department of Psychiatry, Division of Biostatistics, UT Southwestern Medical Center, Dallas, Texas, United States of America
| | - Nahid Attar
- Department of Internal Medicine, Division of Digestive Diseases, UT Southwestern Medical Center, Dallas, Texas, United States of America
| | - Corron Sanders
- Department of Internal Medicine, Division of Digestive Diseases, UT Southwestern Medical Center, Dallas, Texas, United States of America
| | - William J Korzun
- Department of Clinical Laboratory Sciences, School of Allied Health, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - William M Lee
- Department of Internal Medicine, Division of Digestive Diseases, UT Southwestern Medical Center, Dallas, Texas, United States of America
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Chaftari AM, Hachem R, Reitzel R, Jordan M, Jiang Y, Yousif A, Garoge K, Deshmukh P, Al Hamal Z, Jabbour J, Hanania A, Raad S, Jamal M, Raad I. Role of Procalcitonin and Interleukin-6 in Predicting Cancer, and Its Progression Independent of Infection. PLoS One 2015; 10:e0130999. [PMID: 26148092 PMCID: PMC4492776 DOI: 10.1371/journal.pone.0130999] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 05/27/2015] [Indexed: 01/17/2023] Open
Abstract
Procalcitonin (PCT) and Interleukin-6 (IL-6) have emerged as biomarkers for different inflammatory conditions. The purpose of the study was to evaluate the role of PCT and IL-6 as biomarkers of cancer and its progression in a large cohort of patients. This cross-sectional study included residual plasma samples collected from cancer patients, and control subjects without cancer. Levels of PCT and IL-6 were determined by Kryptor compact bioanalyzer. We identified 575 febrile cancer patients, 410 non-febrile cancer patients, and 79 non-cancer individuals. The median PCT level was lower in control subjects (0.029 ng/ml) compared to cancer patients with stage I-III disease (0.127 ng/ml) (p<0.0001) and stage IV disease (0.190 ng/ml) (p<0.0001). It was also higher in febrile cancer patients (0.310 ng/ml) compared to non-febrile cancer patients (0.1 ng/ml) (p<0.0001). Median IL-6 level was significantly lower in the control group (0 pg/ml) than in non-febrile cancer patients with stages I-III (7.376 pg/ml) or stage IV (9.635 pg/ml) (p<0.0001). Our results suggest a potential role for PCT and IL-6 in predicting cancer in non-febrile patients. In addition, PCT is useful in detecting progression of cancer and predicting bacteremia or sepsis in febrile cancer patients.
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Affiliation(s)
- Anne-Marie Chaftari
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
- * E-mail:
| | - Ray Hachem
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
| | - Ruth Reitzel
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
| | - Mary Jordan
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
| | - Ying Jiang
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
| | - Ammar Yousif
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
| | - Kumait Garoge
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
| | - Poonam Deshmukh
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
| | - Zanaib Al Hamal
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
| | - Joseph Jabbour
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
| | - Alexander Hanania
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
| | - Sammy Raad
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
| | - Mohamed Jamal
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
| | - Issam Raad
- Department of Infectious Diseases, Infection Control and Employee Health/Division of Internal Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, United States of America
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The utility of proadrenomedullin and procalcitonin in comparison to C-reactive protein as predictors of sepsis and bloodstream infections in critically ill patients with cancer*. Crit Care Med 2015; 42:2500-7. [PMID: 25083975 DOI: 10.1097/ccm.0000000000000526] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Infections in critically ill patients continue to impose diagnostic and therapeutic challenges. We seek to investigate the utility of proadrenomedullin and procalcitonin as diagnostic and prognostic biomarkers in febrile critically ill patients with cancer and compare their performance with that of C-reactive protein. DESIGN Single-center prospective cohort study. SETTING Tertiary care, academic, university hospital. PATIENTS One hundred fourteen critically ill patients with cancer with fever. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Blood samples were withdrawn on the day of fever onset and 4 to 7 days thereafter, and the serum proadrenomedullin, procalcitonin, and C-reactive protein levels were measured using the Kryptor technology afterward. Of the 114 adult patients, 27 had bloodstream infections, 36 had localized infections, and the remaining had no infections. The area under the receiver operating characteristic curve for bloodstream infection diagnosis was significantly greater for proadrenomedullin (0.70; 95% CI, 0.59-0.82) and procalcitonin (0.71; 95% CI, 0.60-0.83) compared with C-reactive protein (0.53; 95% CI, 0.39-0.66) (p = 0.021 and p = 0.003, respectively). Receiver operating characteristic analysis also showed that proadrenomedullin (p = 0.005) and procalcitonin (p = 0.009) each had a better performance than C-reactive protein in predicting patients' mortality within 2 months after their fever onset. Regarding patients' response to antimicrobial therapy, proadrenomedullin, procalcitonin, and C-reactive protein levels all significantly decreased from baseline to follow-up in responders (p ≤ 0.002), whereas only proadrenomedullin level significantly increased in nonresponders (p < 0.0001). In patients with documented infections, proadrenomedullin (0.81; 95% CI, 0.71-0.92) and procalcitonin (0.73; 95% CI, 0.60-0.85) each had a greater area under the curve compared with C-reactive protein (0.59; 95% CI, 0.45-0.73) as for as predicting response (p = 0.004 and p = 0.043, respectively). However, for all febrile patients, proadrenomedullin had a significantly greater area under the curve for predicting favorable response than procalcitonin (p < 0.0001). CONCLUSION In critically ill patients with cancer, proadrenomedullin and procalcitonin both have a promising role in predicting bloodstream infections in a manner more helpful than C-reactive protein. These two biomarkers were superior to C-reactive protein in the prognostic analysis of response to antimicrobial therapy for those patients with documented infections. However, proadrenomedullin was superior to procalcitonin in predicting response in all febrile patients and was unique in showing increased levels among nonresponders.
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Diagnostic and prognostic value of serum procalcitonin concentrations in primary lung cancers. Clin Biochem 2014; 47:263-7. [PMID: 25218831 DOI: 10.1016/j.clinbiochem.2014.09.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 08/30/2014] [Accepted: 09/02/2014] [Indexed: 01/30/2023]
Abstract
OBJECTIVES 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. DESIGN AND METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Phase II trial of bortezomib plus doxorubicin in hepatocellular carcinoma (E6202): a trial of the Eastern Cooperative Oncology Group. Invest New Drugs 2014; 32:1017-27. [PMID: 24890858 DOI: 10.1007/s10637-014-0111-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 05/09/2014] [Indexed: 12/27/2022]
Abstract
PURPOSE To evaluate the efficacy and tolerability of bortezomib in combination with doxorubicin in patients with advanced hepatocellular carcinoma, and to correlate pharmacodynamic markers of proteasome inhibition with response and survival. EXPERIMENTAL DESIGN This phase II, open-label, multicenter study examined the efficacy of bortezomib (1.3 mg/m(2) IV on d1, 4, 8, 11) and doxorubicin (15 mg/m(2) IV on d1, 8) in 21-day cycles. The primary endpoint was objective response rate. RESULTS Best responses in 38 treated patients were 1 partial response (2.6 %), 10 (26.3 %) stable disease, and 17 (44.7 %) progressive disease; 10 patients were unevaluable. Median PFS was 2.2 months. Median OS was 6.1 months. The most common grade 3 to 4 toxicities were hypertension, glucose intolerance, ascites, ALT elevation, hyperglycemia and thrombosis/embolism. Worse PFS was seen in patients with elevated IL-6, IL-8, MIP-1α and EMSA for NF-κB at the start of treatment. Worse OS was seen in patients with elevated IL-8 and VEGF at the start of treatment. Patients had improved OS if a change in the natural log of serum MIP-1α/CCL3 was seen after treatment. RANTES/CCL5 levels decreased significantly with treatment. CONCLUSIONS The combination of doxorubicin and bortezomib was well-tolerated in patients with hepatocellular carcinoma, but the primary endpoint was not met. Exploratory analyses of markers of proteasome inhibition suggest a possible prognostic and predictive role and should be explored further in tumor types for which bortezomib is efficacious.
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Knockdown of astrocyte elevated gene-1 inhibits growth through suppression of IL-6 secretion in HepG2 human hepatoma cells. Oncol Lett 2013; 7:101-106. [PMID: 24348829 PMCID: PMC3861575 DOI: 10.3892/ol.2013.1645] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 09/30/2013] [Indexed: 11/12/2022] Open
Abstract
Astrocyte-elevated gene-1 (AEG-1) has been reported to be associated with cancer progression in various types of human cancers, including liver cancer. However, to date, the molecular mechanism of AEG-1 action on the growth of liver cancer cells has been poorly elucidated. The present study aimed to investigate the effect of AEG-1 on the proliferation and apoptosis of liver cancer cells and the role of IL-6 in this process using the HepG2 human hepatoma cell line. shRNAs targeting AEG-1 were used to silence the expression of AEG-1. The effects on cell growth were detected by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide, colony formation and cell cycle assays. Apoptosis was analyzed by flow cytometry. The expression of IL-6 was examined by quantitative polymerase chain reaction and enzyme-linked immunosorbent assay, and the phosphorylation of Stat3 was detected by western blotting. AEG-1 knockdown was observed to induce cell proliferation inhibition and apoptosis through the suppression of IL-6 secretion. Stat3, a downstream target of IL-6 signaling, was suppressed in the AEG-1-silenced cells and target genes, including Bcl-2 and crystalin, αB, which are associated with cell survival, were downregulated. Overall, the findings suggest that aberrant AEG-1 expression promotes the growth of HepG2 liver cancer cells, contributing to the progression of liver cancer, which may partly be mediated by IL-6 signaling.
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Serum C-reactive protein and procalcitonin levels in non-small cell lung cancer patients. Contemp Oncol (Pozn) 2013; 17:68-72. [PMID: 23788965 PMCID: PMC3685338 DOI: 10.5114/wo.2013.33777] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 08/22/2012] [Accepted: 09/26/2012] [Indexed: 12/31/2022] Open
Abstract
Aim of the study The basic uses of C-reactive protein (CRP) and procalcitonin (PCT) in clinical practice are in the diagnosis and follow-up of infectious disease. The fact that CRP already achieves high levels in cases with lung cancer, however, limits its diagnostic specificity. Procalcitonin may be an important marker in the differential diagnosis of lung cancer patients who have fever and high CRP levels. Our objective in this study was to determine the levels of CRP and PCT in patients with newly diagnosed non-infectious non-small cell lung cancer (NSCLC) and to relate these results to patient and disease characteristics. Material and methods Serum CRP and PCT levels were measured in 79 histopathologically proven NSCLC patients and 20 healthy controls. Results were compared with demographic and clinical variables in patients with NSCLC. Results Serum CRP concentrations were significantly higher in NSCLC patients compared to the control group [38.30 (7.79–185) mg/dl vs. 7.79 (3.36–26.10) mg/dl; p < 0.001]. There was no significant difference between the two groups in PCT levels (p > 0.05). A mild, positive correlation was found between CRP level and tumor diameter. When comparing CRP levels in the lung cancer patients grouped according to age, sex, smoking status, clinical TNM staging and performance status (PS), the only significant difference found was that for PS score. Conclusions High serum CRP levels in non-infectious NSCLC patients are mainly related to PS status and weakly to tumor size. Adding serum PCT measurement may contribute to exclusion of infections in patients with NSCLC.
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Loock J, Lamprecht P, Gross WL. Acute inflammatory syndrome with elevated procalcitonin induced by mycophenolate sodium. J Rheumatol 2012; 39:658-9. [PMID: 22383357 DOI: 10.3899/jrheum.111083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Shomali W, Hachem R, Chaftari AM, Jiang Y, Bahu R, Jabbour J, Raad S, Al Shuaibi M, Al Wohoush I, Raad I. Can procalcitonin distinguish infectious fever from tumor-related fever in non-neutropenic cancer patients? Cancer 2012; 118:5823-9. [DOI: 10.1002/cncr.27602] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 02/29/2012] [Accepted: 03/07/2012] [Indexed: 02/01/2023]
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Lee J, Lim KT. Preventive effect of phytoglycoprotein (38 kDa) on expression of alpha-fetoprotein and matrix metalloproteinase-9 in diethylnitrosamine-treated ICR mice. Drug Chem Toxicol 2011; 35:277-84. [PMID: 21939363 DOI: 10.3109/01480545.2011.600762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Metastasis is one of the major causes of cancer-associated mortality. Aberrant expression of matrix metalloproteinase-9 (MMP-9) has been implicated in the metastasis of various cancer cells. The aim of this study was to investigate the inhibitory effect of a glycoprotein (38 kDa) isolated from Styrax japonica Siebold et al Zuccarini (SJSZ) on metastasis of hepatocellular carcinoma (HCC) in diethylnitrosamine (DEN)-treated imprinting control region (ICR) mice. To study the chemopreventive effect of SJSZ glycoprotein on the metastasis of HCC, ICR mice were injected intraperitoneally with DEN (75 mg/kg) for 11 weeks. Subsequently, we evaluated nitric oxide (NO), alpha-fetoprotein (AFP), activator protein (AP)-1, cyclooxygenase (COX)-2, inducible nitric oxide synthase (iNOS), matrix metalloproteinase (MMP)-9, and interleukin (IL)-6 using biochemical reaction, immunoblot analysis, and reverse-transcription polymerase chain reaction. Here, the results showed that SJSZ glycoprotein (10 mg/kg body weight) reduced the production of NO in DEN (75 mg/kg)-treated ICR mice. Also, it suppressed the activity of AFP, AP-1 (c-Jun and c-Fos), COX-2, iNOS, and MMP-9. Taken together, SJSZ glycoprotein inhibits the activity of MMP-9 as a metastasis factor.
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Affiliation(s)
- Jin Lee
- Molecular Biochemistry Laboratory, Biotechnology Research Institute and Center for the Control of Animal Hazards Using Biotechnology (BK21), Chonnam National University, Gwang-ju, South Korea
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Reinhart K, Meisner M. Biomarkers in the critically ill patient: procalcitonin. Crit Care Clin 2011; 27:253-63. [PMID: 21440200 DOI: 10.1016/j.ccc.2011.01.002] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Infection and/or sepsis biomarkers should help to make the diagnosis and thus initiate therapy earlier, help to differentiate between infectious and sterile inflammation, allow the use of more-specific antimicrobials, shorten the time of antimicrobial use, and ideally identify distinct phenotypes that may benefit from specific adjunctive sepsis therapies. Procalcitonin (PCT) was proposed as a sepsis and infection marker more than 15 years ago. Meanwhile, PCT has been evaluated in various clinical settings. In this review the present use of PCT on the ICU and in critically ill patients is summarized, included it's role for diagnosis of severe sepsis and septic shock and antibiotic stewardship with PCT.
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Affiliation(s)
- Konrad Reinhart
- Clinic of Anaesthesiology and Intensive Care Medicine, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07740 Jena, Germany
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Spicer J, Brodt P, Ferri L. Role of Inflammation in the Early Stages of Liver Metastasis. LIVER METASTASIS: BIOLOGY AND CLINICAL MANAGEMENT 2011. [DOI: 10.1007/978-94-007-0292-9_6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Neumann S, Kaup FJ, Scheulen S. Interleukin-6 (IL-6) serum concentrations in dogs with hepatitis and hepatic tumours compared with those with extra-hepatic inflammation and tumours. ACTA ACUST UNITED AC 2010; 21:539-544. [PMID: 23049492 PMCID: PMC3461252 DOI: 10.1007/s00580-010-1126-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 11/01/2010] [Indexed: 11/26/2022]
Abstract
Cytokines are part of pathogenesis in many diseases. Their measurement could be interesting for diagnostic purposes. One cytokine which participates in different inflammatory and neoplastic diseases is interleukin-6 (IL-6). The aim of this study was to investigate the IL-6 serum concentration in dogs with different liver diseases to show if there is any association between the cytokine serum level and the disease aetiology or the degree of the disease. IL-6 was measured in dogs with acute hepatitis, chronic hepatitis of different degrees and primary and secondary liver tumours. The data were compared with clinically healthy dogs and dogs with extra-hepatic diseases. For measurement, a commercial ELISA Kit (R&D Systems) was used. Compared with clinically healthy dogs and dogs with diabetes mellitus, all dogs with an intra- or extra-hepatic inflammatory or neoplastic disease have increased serum levels of IL-6. Dogs with acute hepatitis have significantly increased IL-6 serum concentrations compared with dogs with chronic hepatitis (P < 0.05). No significant difference between mild and moderate chronic hepatitis exists (P > 0.05). Dogs with secondary liver tumours have significantly increased IL-6 serum concentrations in comparison to dogs with primary liver tumours (P < 0.01), but both groups have comparable IL-6 serum concentration to dogs with extra-hepatic tumours. Measurement of IL-6 serum concentration may help differentiate between acute and chronic hepatitis and between primary and secondary liver tumours. Further information about the aetiology of the liver disease cannot be obtained by measuring IL-6 in the serum.
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Affiliation(s)
- Stephan Neumann
- Small Animal Clinic, Institute of Veterinary Medicine, University of Göttingen, Burckhardtweg 2, 37077 Göttingen, Germany
| | | | - Sonja Scheulen
- Small Animal Clinic, Institute of Veterinary Medicine, University of Göttingen, Burckhardtweg 2, 37077 Göttingen, Germany
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Circulating procalcitonin in aseptic carcinoma patients: a specificity study with 18F-fluorodeoxyglucose positron-emission tomography/computed tomography as benchmark. Clin Chem Lab Med 2010; 48:1163-5. [DOI: 10.1515/cclm.2010.214] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Maeda S, Hikiba Y, Sakamoto K, Nakagawa H, Hirata Y, Hayakawa Y, Yanai A, Ogura K, Karin M, Omata M. Ikappa B kinasebeta/nuclear factor-kappaB activation controls the development of liver metastasis by way of interleukin-6 expression. Hepatology 2009; 50:1851-60. [PMID: 19821485 DOI: 10.1002/hep.23199] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
UNLABELLED Nuclear factor kappaB (NF-kappaB) plays an important role in the regulation of innate immune responses, apoptosis, inflammation, and oncogenesis. NF-kappaB activation in the liver was observed after intrasplenic administration of a lung carcinoma cell line, LLC, which induces liver metastasis. To explore the role of Ikappa B kinase beta (IKKbeta), which is the critical kinase of the IKK complex, and NF-kappaB activation in metastasis, we injected LLC cells into hepatocyte-specific IKKbeta knockout mice (Ikkbeta(Deltahep)), whole-liver knockout (Ikkbeta(DeltaL+H)) mice, and control (Ikkbeta(F/F)) mice. Ikkbeta(DeltaL+H) mice developed liver metastasis with significantly lower liver weights and fewer metastatic foci compared to Ikkbeta(Deltahep) and Ikkbeta(F/F) mice. Furthermore, intrasplenic LLC injection induced the messenger RNA (mRNA) expression of interleukin (IL)-6 and IL-1beta in Ikkbeta(F/F) mice, whereas these genes were less expressed in Ikkbeta(DeltaL+H) mice. IL-6(-/-) mice and treatment with anti-IL-6 receptor antibody showed a lesser degree of metastatic tumor, indicating that IL-6 is associated with liver metastasis. CONCLUSION Collectively, these observations suggest that IKKbeta/NF-kappaB activation controls the development of liver metastasis by way of IL-6 expression and is a potential target for the development of antimetastatic drugs.
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Affiliation(s)
- Shin Maeda
- Department of Gastroenterology, University of Tokyo, Tokyo, Japan.
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Algeciras-Schimnich A, Preissner CM, Theobald JP, Finseth MS, Grebe SKG. Procalcitonin: a marker for the diagnosis and follow-up of patients with medullary thyroid carcinoma. J Clin Endocrinol Metab 2009; 94:861-8. [PMID: 19088163 PMCID: PMC2730230 DOI: 10.1210/jc.2008-1862] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONTEXT Calcitonin (CT) is the main medullary thyroid carcinoma (MTC) tumor marker. However, it has several limitations, including a concentration-dependent biphasic half-life, sensitivity to rapid in vitro degradation, and the presence of different isoforms/fragments. Procalcitonin (PCT), the prohormone of calcitonin, is free of these limitations but is currently used only as a sepsis marker. OBJECTIVES The objective of the study was to determine whether PCT is suited as a MTC tumor marker by comparing the diagnostic performance of PCT with that of CT in MTC. DESIGN PCT and CT were measured in a total of 835 subjects, including normal volunteers (n = 197) and patients with active-MTC (n = 91), cured-MTC (n = 42), neuroendocrine tumors (n = 225), mastocytosis (n = 48), follicular cell-derived thyroid carcinoma (cured = 120, persistent/recurrent = 55), and benign thyroid disease (n = 57). RESULTS PCT levels were significantly higher in the active-MTC patients (mean 126.4 ng/ml) than the cured-MTC patients (mean <0.1 ng/ml). The overall concordance between the two markers was 95.7% (kappa = 0.81). Receiver-operating characteristic curve analysis showed no significant difference in diagnostic performance between CT and PCT. PCT's diagnostic sensitivity and specificity were 91 and 96%, respectively. The corresponding values for CT were 99 and 98%. Analyte stability studies showed that CT is very unstable in vitro with a decrease of 35-50% from the original value 24 h after the blood draw, whereas PCT levels did not significantly change during this time. CONCLUSIONS A strong correlation was observed between PCT and CT levels in patients with MCT. Given PCT's greater analytical stability, we conclude that it represents a promising complementary MTC tumor marker.
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