Procalcitonin and C-reactive protein as early markers of postoperative intra-abdominal infection in patients operated on colorectal cancer
Purpose The aim of this study was to evaluate the accuracy of serum procalcitonin (PCT) and C-reactive protein (CRP) for early diagnosis of postoperative intra-abdominal infections (PIAI) after elective surgery for colorectal cancer. Methods Prospective observational study including patients operate...
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| Veröffentlicht in: | International journal of colorectal disease 2017-12, Vol.32 (12), p.1771-1774 |
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| container_title | International journal of colorectal disease |
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| creator | Domínguez-Comesaña, E. Estevez-Fernández, S. M. López-Gómez, V. Ballinas-Miranda, J. Domínguez-Fernández, R. |
| description | Purpose
The aim of this study was to evaluate the accuracy of serum procalcitonin (PCT) and C-reactive protein (CRP) for early diagnosis of postoperative intra-abdominal infections (PIAI) after elective surgery for colorectal cancer.
Methods
Prospective observational study including patients operated on for colorectal cancer between January and December of 2015 was performed. Serum PCT and CRP levels were measured before surgery and daily until postoperative day 3.
Results
One hundred twenty patients were included. Seven patients (5.8%) had PIAI. PCT levels were significantly higher in patients with PIAI on postoperative days 1 and 3, whereas CRP levels only were significantly more elevated on postoperative day 3. The ratio between CRP levels on postoperative day 3 and CRP levels on postoperative days 2 (CRP D3/CRP D2) and 1 (CRP D3/CRP D1) was significantly higher in patients with PIAI. PCT on postoperative day 3, for a cutoff of 0.45 ng/mL, had the best sensitivity (100%) with a specificity of 73.8%. The ratio CRP D3/CRP D1 yielded the higher specificity and positive predictive value (90.9 and 27.3%, respectively, for a cutoff of 1.8). The higher negative predictive value was obtained for PCT on postoperative days 1 and 3 (100%, with cutoff of 0.76 and 0.45 ng/mL, respectively) and for CRP on postoperative day 3 (100% with cutoff of 10 mg/dL).
Conclusion
PCT and CRP serum levels are associated with the appearance of PIAI after colorectal cancer surgery, although the positive predictive values were low for both PCT and CRP. However, the negative predictive values were high. |
| doi_str_mv | 10.1007/s00384-017-2902-9 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1940196583</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714488462</galeid><sourcerecordid>A714488462</sourcerecordid><originalsourceid>FETCH-LOGICAL-c439t-4ee7664a67a7c602da60380078cb3d1f454d6d4206220d569d4f53f8d590acfe3</originalsourceid><addsrcrecordid>eNp1kc9u1DAQxi1ERZfCA3BBkbj04tZ2HMc-VisoSJXg0J4trz2pXBI72FmkvgJPzaRb_grkgz0zv2_kmY-QV5ydccb688pYqyVlvKfCMEHNE7LhshWUCyWekg0WDOWm08fkea13DGPVy2fkWGjDtWzbDfn2qWTvRh-XnGJqXArNlhZwfolfoZlLXmBN1wZcGe-byZXPUGqTh2bOdckzFPdAxrQUR90u5CkmN2I8APbICV_NjAykBWUPPIQG8z6PuSCDsHfJQ3lBjgY3Vnj5eJ-Qm3dvr7fv6dXHyw_biyvqZWsWKgF6paRTveu9YiI4hVvAdWi_awMfZCeDClIwJQQLnTJBDl076NAZ5vwA7Qk5PfTF6b7soS52itXDOLoEeV8tN5JxozrdIvrmL_Qu7wvOt1KqY7hC0_2ibt0IFifPuAu_NrUXPZdSa6kEUmf_oPAEmKLPCYaI-T8E_CDwJddaYLBziWjAveXMrv7bg_8WbbWr_9ag5vXjh_e7CcJPxQ_DERAHoGIp3UL5baL_dv0OMoG7Iw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1965043395</pqid></control><display><type>article</type><title>Procalcitonin and C-reactive protein as early markers of postoperative intra-abdominal infection in patients operated on colorectal cancer</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Domínguez-Comesaña, E. ; Estevez-Fernández, S. M. ; López-Gómez, V. ; Ballinas-Miranda, J. ; Domínguez-Fernández, R.</creator><creatorcontrib>Domínguez-Comesaña, E. ; Estevez-Fernández, S. M. ; López-Gómez, V. ; Ballinas-Miranda, J. ; Domínguez-Fernández, R.</creatorcontrib><description>Purpose
The aim of this study was to evaluate the accuracy of serum procalcitonin (PCT) and C-reactive protein (CRP) for early diagnosis of postoperative intra-abdominal infections (PIAI) after elective surgery for colorectal cancer.
Methods
Prospective observational study including patients operated on for colorectal cancer between January and December of 2015 was performed. Serum PCT and CRP levels were measured before surgery and daily until postoperative day 3.
Results
One hundred twenty patients were included. Seven patients (5.8%) had PIAI. PCT levels were significantly higher in patients with PIAI on postoperative days 1 and 3, whereas CRP levels only were significantly more elevated on postoperative day 3. The ratio between CRP levels on postoperative day 3 and CRP levels on postoperative days 2 (CRP D3/CRP D2) and 1 (CRP D3/CRP D1) was significantly higher in patients with PIAI. PCT on postoperative day 3, for a cutoff of 0.45 ng/mL, had the best sensitivity (100%) with a specificity of 73.8%. The ratio CRP D3/CRP D1 yielded the higher specificity and positive predictive value (90.9 and 27.3%, respectively, for a cutoff of 1.8). The higher negative predictive value was obtained for PCT on postoperative days 1 and 3 (100%, with cutoff of 0.76 and 0.45 ng/mL, respectively) and for CRP on postoperative day 3 (100% with cutoff of 10 mg/dL).
Conclusion
PCT and CRP serum levels are associated with the appearance of PIAI after colorectal cancer surgery, although the positive predictive values were low for both PCT and CRP. However, the negative predictive values were high.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-017-2902-9</identifier><identifier>PMID: 28918433</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Abdomen ; Abscess ; Aged ; Aged, 80 and over ; Biomarkers - blood ; C-reactive protein ; C-Reactive Protein - metabolism ; Calcitonin - blood ; Cancer patients ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - surgery ; Diagnosis ; Digestive System Surgical Procedures - adverse effects ; Early Diagnosis ; Female ; Gastroenterology ; Health aspects ; Hepatology ; Humans ; Infection ; Internal Medicine ; Intra-abdominal infection ; Intraabdominal Infections - blood ; Intraabdominal Infections - diagnosis ; Intraabdominal Infections - etiology ; Low density lipoprotein ; Male ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Metronidazole ; Middle Aged ; Predictive Value of Tests ; Procalcitonin ; Proctology ; Prospective Studies ; Reproducibility of Results ; Serum levels ; Short Communication ; Surgery ; Time Factors ; Treatment Outcome</subject><ispartof>International journal of colorectal disease, 2017-12, Vol.32 (12), p.1771-1774</ispartof><rights>Springer-Verlag GmbH Germany 2017</rights><rights>COPYRIGHT 2017 Springer</rights><rights>International Journal of Colorectal Disease is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-4ee7664a67a7c602da60380078cb3d1f454d6d4206220d569d4f53f8d590acfe3</citedby><cites>FETCH-LOGICAL-c439t-4ee7664a67a7c602da60380078cb3d1f454d6d4206220d569d4f53f8d590acfe3</cites><orcidid>0000-0002-0752-1664</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-017-2902-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-017-2902-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28918433$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Domínguez-Comesaña, E.</creatorcontrib><creatorcontrib>Estevez-Fernández, S. M.</creatorcontrib><creatorcontrib>López-Gómez, V.</creatorcontrib><creatorcontrib>Ballinas-Miranda, J.</creatorcontrib><creatorcontrib>Domínguez-Fernández, R.</creatorcontrib><title>Procalcitonin and C-reactive protein as early markers of postoperative intra-abdominal infection in patients operated on colorectal cancer</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Purpose
The aim of this study was to evaluate the accuracy of serum procalcitonin (PCT) and C-reactive protein (CRP) for early diagnosis of postoperative intra-abdominal infections (PIAI) after elective surgery for colorectal cancer.
Methods
Prospective observational study including patients operated on for colorectal cancer between January and December of 2015 was performed. Serum PCT and CRP levels were measured before surgery and daily until postoperative day 3.
Results
One hundred twenty patients were included. Seven patients (5.8%) had PIAI. PCT levels were significantly higher in patients with PIAI on postoperative days 1 and 3, whereas CRP levels only were significantly more elevated on postoperative day 3. The ratio between CRP levels on postoperative day 3 and CRP levels on postoperative days 2 (CRP D3/CRP D2) and 1 (CRP D3/CRP D1) was significantly higher in patients with PIAI. PCT on postoperative day 3, for a cutoff of 0.45 ng/mL, had the best sensitivity (100%) with a specificity of 73.8%. The ratio CRP D3/CRP D1 yielded the higher specificity and positive predictive value (90.9 and 27.3%, respectively, for a cutoff of 1.8). The higher negative predictive value was obtained for PCT on postoperative days 1 and 3 (100%, with cutoff of 0.76 and 0.45 ng/mL, respectively) and for CRP on postoperative day 3 (100% with cutoff of 10 mg/dL).
Conclusion
PCT and CRP serum levels are associated with the appearance of PIAI after colorectal cancer surgery, although the positive predictive values were low for both PCT and CRP. However, the negative predictive values were high.</description><subject>Abdomen</subject><subject>Abscess</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biomarkers - blood</subject><subject>C-reactive protein</subject><subject>C-Reactive Protein - metabolism</subject><subject>Calcitonin - blood</subject><subject>Cancer patients</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - surgery</subject><subject>Diagnosis</subject><subject>Digestive System Surgical Procedures - adverse effects</subject><subject>Early Diagnosis</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Health aspects</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Infection</subject><subject>Internal Medicine</subject><subject>Intra-abdominal infection</subject><subject>Intraabdominal Infections - blood</subject><subject>Intraabdominal Infections - diagnosis</subject><subject>Intraabdominal Infections - etiology</subject><subject>Low density lipoprotein</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Metronidazole</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Procalcitonin</subject><subject>Proctology</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>Serum levels</subject><subject>Short Communication</subject><subject>Surgery</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kc9u1DAQxi1ERZfCA3BBkbj04tZ2HMc-VisoSJXg0J4trz2pXBI72FmkvgJPzaRb_grkgz0zv2_kmY-QV5ydccb688pYqyVlvKfCMEHNE7LhshWUCyWekg0WDOWm08fkea13DGPVy2fkWGjDtWzbDfn2qWTvRh-XnGJqXArNlhZwfolfoZlLXmBN1wZcGe-byZXPUGqTh2bOdckzFPdAxrQUR90u5CkmN2I8APbICV_NjAykBWUPPIQG8z6PuSCDsHfJQ3lBjgY3Vnj5eJ-Qm3dvr7fv6dXHyw_biyvqZWsWKgF6paRTveu9YiI4hVvAdWi_awMfZCeDClIwJQQLnTJBDl076NAZ5vwA7Qk5PfTF6b7soS52itXDOLoEeV8tN5JxozrdIvrmL_Qu7wvOt1KqY7hC0_2ibt0IFifPuAu_NrUXPZdSa6kEUmf_oPAEmKLPCYaI-T8E_CDwJddaYLBziWjAveXMrv7bg_8WbbWr_9ag5vXjh_e7CcJPxQ_DERAHoGIp3UL5baL_dv0OMoG7Iw</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>Domínguez-Comesaña, E.</creator><creator>Estevez-Fernández, S. M.</creator><creator>López-Gómez, V.</creator><creator>Ballinas-Miranda, J.</creator><creator>Domínguez-Fernández, R.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0752-1664</orcidid></search><sort><creationdate>20171201</creationdate><title>Procalcitonin and C-reactive protein as early markers of postoperative intra-abdominal infection in patients operated on colorectal cancer</title><author>Domínguez-Comesaña, E. ; Estevez-Fernández, S. M. ; López-Gómez, V. ; Ballinas-Miranda, J. ; Domínguez-Fernández, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-4ee7664a67a7c602da60380078cb3d1f454d6d4206220d569d4f53f8d590acfe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdomen</topic><topic>Abscess</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biomarkers - blood</topic><topic>C-reactive protein</topic><topic>C-Reactive Protein - metabolism</topic><topic>Calcitonin - blood</topic><topic>Cancer patients</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Colorectal Neoplasms - surgery</topic><topic>Diagnosis</topic><topic>Digestive System Surgical Procedures - adverse effects</topic><topic>Early Diagnosis</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Health aspects</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Infection</topic><topic>Internal Medicine</topic><topic>Intra-abdominal infection</topic><topic>Intraabdominal Infections - blood</topic><topic>Intraabdominal Infections - diagnosis</topic><topic>Intraabdominal Infections - etiology</topic><topic>Low density lipoprotein</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Metronidazole</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Procalcitonin</topic><topic>Proctology</topic><topic>Prospective Studies</topic><topic>Reproducibility of Results</topic><topic>Serum levels</topic><topic>Short Communication</topic><topic>Surgery</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Domínguez-Comesaña, E.</creatorcontrib><creatorcontrib>Estevez-Fernández, S. M.</creatorcontrib><creatorcontrib>López-Gómez, V.</creatorcontrib><creatorcontrib>Ballinas-Miranda, J.</creatorcontrib><creatorcontrib>Domínguez-Fernández, R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Domínguez-Comesaña, E.</au><au>Estevez-Fernández, S. M.</au><au>López-Gómez, V.</au><au>Ballinas-Miranda, J.</au><au>Domínguez-Fernández, R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Procalcitonin and C-reactive protein as early markers of postoperative intra-abdominal infection in patients operated on colorectal cancer</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>32</volume><issue>12</issue><spage>1771</spage><epage>1774</epage><pages>1771-1774</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Purpose
The aim of this study was to evaluate the accuracy of serum procalcitonin (PCT) and C-reactive protein (CRP) for early diagnosis of postoperative intra-abdominal infections (PIAI) after elective surgery for colorectal cancer.
Methods
Prospective observational study including patients operated on for colorectal cancer between January and December of 2015 was performed. Serum PCT and CRP levels were measured before surgery and daily until postoperative day 3.
Results
One hundred twenty patients were included. Seven patients (5.8%) had PIAI. PCT levels were significantly higher in patients with PIAI on postoperative days 1 and 3, whereas CRP levels only were significantly more elevated on postoperative day 3. The ratio between CRP levels on postoperative day 3 and CRP levels on postoperative days 2 (CRP D3/CRP D2) and 1 (CRP D3/CRP D1) was significantly higher in patients with PIAI. PCT on postoperative day 3, for a cutoff of 0.45 ng/mL, had the best sensitivity (100%) with a specificity of 73.8%. The ratio CRP D3/CRP D1 yielded the higher specificity and positive predictive value (90.9 and 27.3%, respectively, for a cutoff of 1.8). The higher negative predictive value was obtained for PCT on postoperative days 1 and 3 (100%, with cutoff of 0.76 and 0.45 ng/mL, respectively) and for CRP on postoperative day 3 (100% with cutoff of 10 mg/dL).
Conclusion
PCT and CRP serum levels are associated with the appearance of PIAI after colorectal cancer surgery, although the positive predictive values were low for both PCT and CRP. However, the negative predictive values were high.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28918433</pmid><doi>10.1007/s00384-017-2902-9</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0002-0752-1664</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0179-1958 |
| ispartof | International journal of colorectal disease, 2017-12, Vol.32 (12), p.1771-1774 |
| issn | 0179-1958 1432-1262 |
| language | eng |
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| subjects | Abdomen Abscess Aged Aged, 80 and over Biomarkers - blood C-reactive protein C-Reactive Protein - metabolism Calcitonin - blood Cancer patients Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - surgery Diagnosis Digestive System Surgical Procedures - adverse effects Early Diagnosis Female Gastroenterology Health aspects Hepatology Humans Infection Internal Medicine Intra-abdominal infection Intraabdominal Infections - blood Intraabdominal Infections - diagnosis Intraabdominal Infections - etiology Low density lipoprotein Male Medical research Medicine Medicine & Public Health Medicine, Experimental Metronidazole Middle Aged Predictive Value of Tests Procalcitonin Proctology Prospective Studies Reproducibility of Results Serum levels Short Communication Surgery Time Factors Treatment Outcome |
| title | Procalcitonin and C-reactive protein as early markers of postoperative intra-abdominal infection in patients operated on colorectal cancer |
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