Serum Procalcitonin Levels Are Elevated in Esophageal Cancer Patients with Postoperative Infectious Complications

Department of Surgery 1, Critical Care Medicine and Anesthesiology, School of Medicine, Iwate Medical University, Morioka, Japan.
European Surgical Research (Impact Factor: 2.47). 01/2005; 37(1):22-8. DOI: 10.1159/000083144
Source: PubMed


The normal systemic inflammatory response to surgical stimuli often makes early diagnosis of postoperative infections difficult.
We investigated whether serum procalcitonin (PCT) levels may be a useful marker of bacterial infections in patients after invasive surgery.
The subjects were 40 patients who had undergone radical surgery for esophageal carcinoma by a right thoracoabdominal approach. Nine patients were diagnosed to have a postoperative infection during the first 7 days after surgery. Changes in serum PCT levels were compared between the group diagnosed to have postoperative infection (infection group) and the group without infection (noninfection group).
The postoperative serum PCT levels were significantly higher in the infection group than in the noninfection group (ANOVA: p < 0.01). Serum PCT peaked on postoperative day (POD) 5 in the infection group (8.7 +/- 8.2 ng/ml, mean +/- SD) and on POD 1 in the noninfection group (0.5 +/- 0.5 ng/ml). No significant differences were found between the two groups in leukocyte count, serum CRP or cytokine levels. The receiver operating characteristics (ROC) curve was constructed for infection identification. The area under the ROC curve for peak postoperative PCT was 0.968, and at a cutoff value of 2.0 ng/ml, the sensitivity was 89% and the specificity was 93%.
Serum PCT levels may be useful for the early diagnosis of postoperative infectious complications.

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    • "Both parameters showed similar trends on subsequent days, which means that, as IL-6 is measured mostly experimentally, measurements of PCT should be sufficient to provide the necessary information. Ito and colleagues actually found that PCT is better for monitoring the development of sepsis in patients who had undergone oesophageal surgery for carcinoma; however they were able to predict sepsis one day earlier than in our study [22]. Unlike our patients though, their patients did not receive preoperative chemotherapy. "
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