【摘要】 目的:探讨降钙素原(procalcitonin, PCT)检测在肺癌发热患者感染诊断中的应用价值及与癌性发热鉴别诊断中的应用。方法:回顾性收集2013年1月至2018年10月在我院行血清PCT检测的140例肺癌患者的临床及实验室资料,将患者分为感染伴发热、感染不伴发热、无感染伴癌性发热、无感染无发热4组,比较4组患者的血清PCT水平,绘制接受者操作特性(receiver operating characteristic,ROC)曲线评价血清PCT在肺癌感染与癌性发热鉴别诊断中的价值。结果:感染肺癌患者中,小细胞肺癌的血清PCT水平高于非小细胞肺癌(4.322 vs 0.142;Z=-4.240,P<0.001);有转移患者的血清PCT水平高于无转移患者(0.609 vs 0.111;Z=-2.517,P=0.006)。感染伴发热血清PCT水平为0.652(0.290～1.147)μg/L最高、其次为癌性发热无感染组0.439(0.174～1.074)μg/L、再次为感染不伴发热组0.378(0.117～0.581)μg/L、最低为无感染无发热组0.126(0.038～0.451)μg/L。PCT诊断肺癌患者感染的最佳截断点为0.349μg/L,曲线下面积为0.645±0.043,灵敏度、特异度分别为0.449、0.769;PCT诊断未发热肺癌患者感染的最佳截断点为0.098μg/L,曲线下面积为0.678±0.051,灵敏度、特异度分别为0.518、0.763;PCT诊断发热肺癌患者感染的最佳截断点为0.954μg/L,曲线下面积为0.704±0.074,灵敏度、特异度分别为0.341、0.939。结论:血清PCT作为一种快速、简单、易获得的一项实验室诊断指标,可以作为肺癌发热患者感染诊断及的一项参考指标,但血清PCT水平升高并不完全意味着感染。更多还原

【Abstract】 Objective: To evaluate the value of serum procalcitonin(PCT) level in the differential diagnosis of infection and cancerous fever of patients with malignant tumor. Methods: We retrospectively collected clinical and laboratory data of 140 patients with lung cancer who underwent PCT detection in Qingdao NO. 9 People’s Hospital from January 2013 to October 2018. The patients were divided into four groups: the infection with fever group, the infection without fever group, the cancerous fever without infection group and the non infection without fever group. Level of PCT in four groups were compared, and receiver operating characteristic curve was drawn to evaluate the value of PCT in differential diagnosis in lung cancer infection and cancerous fever. Results: The serum PCT level of small cell lung cancer patients was higher than that of non-small cell lung cancer patients(4.322 vs 0.142; Z=-4.240, P<0.001); the serum PCT level of patients with metastasis was higher than that of patients without metastasis(0.609 vs 0.111; Z=-2.517, P=0.006). The serum PCT level was 0.652(0.290～1.147) ug/L in the infection with fever group, 0.439(0.174～1.074) ug/L in the cancerous fever without infection group, 0.378(0.117～0.581) ug/L in the infection without fever group, and 0.126(0.038～0.451) ug/L in the non infection without fever group. The best cut-off point of PCT for diagnosis of lung cancer was 0.349 ug/L, the area under the curve was 0.645±0.043, and the sensitivity and specificity were 0.449 and 0.769, respectively. The best cut-off point of PCT for diagnosis of infection without fever in lung cancer patients was 0.098 ug/L, and the area under the curve was 0.678±0.051. The sensitivity and specificity were 0.518 and 0.763, respectively. The best cut-off point of PCT for diagnosis of infection with fever in lung cancer patients was 0.954 ug/L, and the area under the curve was 0.704±0.074. The sensitivity and specificity were 0.341 and 0.939, respectively. Conclusion: Serum PCT, as a rapid, simple and easily available laboratory diagnostic index, can be used as a reference for the diagnosis of infection in patients with lung cancer fever. However, elevated serum PCT level does not always mean infection.更多还原