[Diagnostic values of procalcitonin, interleukin-6, C reactive protein and serum amyloid A in sepsis]

Yang Fu, Jie Chen, Bei Cai, Jun-Long Zhang, Li-Xin Li, Lan-Lan Wang
Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition 2012, 43 (5): 702-5

OBJECTIVE: To evaluate the diagnostic values of procalcitonin (PCT), C reactive protein (CRP), interleukin-6 (IL-6), serum amyloid A (SAA) in septic patients.

METHODS: This study totally enrolled 390 patients who were admitted to West China Hospital, Sichuan University from March to November 2011 with septic manifestation. The patients were divided into sepsis group (n = 203) and non-sepsis group (n = 187) according to clinical infectious disease standard. PCT and IL-6 were measured by automatic electrochemiluminescence (ECL) analyser. CRP was measured by rate immunonephelometric analyser, SAA was measured by fixed time nephelometric method. The diagnostic powers of these four biomakers were constructed by receiver operating characteristics (ROC) curves.

RESULTS: There were statistically significant differences on the values of PCT, CRP, IL-6, SAA between sepsis group and non-sepsis group. PCT had an AUC value of 0. 919 (P < 0.05) which was higher than that of CRP, IL-6, and SAA (P < 0.05). CRP performed with an AUC of 0.755 (P < 0.05), IL-6 with an AUC of 0.786 (P < 0.05), and SAA with the lowest AUC of 0.645 (P < 0.05). The combination AUC was 0.892 (P < 0.05) and there was no statistically significant difference when compared to PCT. As an early diagnostic indicator of sepsis, the cut-off value of PCT was 1.18 ng/mL, with sensitivity of 84.7%, specific of 83.4%, while Youden index was 0.681, positive predict value was 64.1%, negative predict value was 75.8%, positive likelihood ratio was 5.10, negative likelihood ratio was 0.18, respectively. A statistically significant difference was available on the value of PCT in septic patients between ICU and non-ICU.

CONCLUSION: PCT as an early independent biomarker for sepsis is superior to immune inflammatory biomarkers (CRP, IL-6, SAA), also is better than the combination of these four biomarkers for economic effect.

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