Giá trị của procalcitonin huyết tương trong dự đoán cấy máu dương tính ở bệnh nhân ung thư nghi ngờ nhiễm khuẩn huyết

Abstract

In cancer patients, the risk of sepsis is increased due to immunosuppression and treatmentrelated interventions. Procalcitonin (PCT) is a biomarker that plays an important role in predicting positive blood cultures, early diagnosis, and monitoring of sepsis in cancer patients with suspected sepsis.This crosssectional study was conducted on 57 cancer patients with suspected sepsis and positive blood cultures and 65 cancer patients with suspected sepsis and negative blood cultures at K Hospital, to determine the diagnostic value of plasma PCT in predicting positive blood cultures in cancer patients with suspected sepsis.Plasma PCT concentrations were measured using the electrochemiluminescence immunoassay (ECLIA). The results showed that the median PCT level in the positive blood culture group was 2.29 ng/mL (95% CI: 1.02 – 5.98) compared to 0.457 ng/mL (95% CI: 0.368 – 0.635) in the negative blood culture group. The difference was statistically significant (p = 0.0001 < 0.05). ROC curve analysis demonstrated an AUC of 0.7507 for PCT.The predictive value of PCT for positive blood cultures at a cutoff of 2 ng/mL was as follows: sensitivity 52.6% (95% CI: 39.0 – 66.0); specificity 93.8% (95% CI: 85.0 – 98.3); positive predictive value 88.2%; and negative predictive value 69.3%.Thus, at a PCT cutoff of 2 ng/mL, plasma procalcitonin demonstrates useful value in predicting positive blood cultures in cancer patients with suspected sepsis. The use of PCT may help identify sepsis, guide appropriate antibiotic use, and reduce delays in treatment.