降钙素原在感染热与肿瘤热鉴别诊断中的临床应用

Clinical application of procalcitonin in differential diagnosis of infection fever and tumor fever

发热是肿瘤患者常见的临床表现之一,在鉴别肿瘤患者属于肿瘤性发热还是感染性发热是临床医生的难点之一。通常情况下,肿瘤热通常属于排它性诊断,应用抗菌药物无效,而感染热通常由病原菌等各种致病因素引起。白细胞、中性粒细胞百分率、C-反应蛋白在单纯肿瘤发热或肿瘤合并感染发热的患者中均可出现升高,缺乏特异性。降钙素原可作为感染的生物标记物,其灵敏度高,特异性强,对比单纯肿瘤发热患者,肿瘤合并感染发热的患者PCT水平明显升高,通过其水平的高低,为临床判断是否需要进行抗感染治疗提供了理论依据。

Fever is one of the common clinical manifestations of cancer patients,and it is one of the difficulties for clinicians to identify whether tumor patients are neoplastic or infectious.In general,tumor fever is usually an exclusive diagnosis,the application of antibacterial drugs is ineffective,and infection fever is usually caused by various pathogenic factors such as pathogenic bacteria.The percentage of white blood cells,neutrophils and C-reactive protein can be elevated in patients with tumor fever alone or with tumor and infection fever,and lacked specificity.Procalcitonin can be used as a biomarker for infection,withhigh sensitivity and specificity.Compared with patients with tumor fever alone,the PCT level of patients with tumor and infection fever is significantly increased,and the level of PCT level provides a theoretical basis for clinical judgment on whether anti-infection treatment is needed.