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Traditional and new markers of infection in adult cancer patients and the possible interfering effect of underlying malignancy on these markers

Abstract
The purpose of the present study was to compare the procalcitonin (PCT),
neopterin, interleukin-8 (IL-8), interleukin-10 (IL-10) and
interleukin-12 (IL-12) levels with those of erythrocyte sedimentation rate (ESR)
and C-reactive protein (CRP) in cancer patients with (56) and
without infection (36) and to evaluate their ability to differentiate
infections from neoplastic fever (n = 10).

The infection group had statistically higher levels of CRP
(91 vs. 19 mg/l, p < 0.001), PCT (0.28 vs.0.12 ng/ml, p < 0.001), neopterin
(12.8 pg/mL vs. 4.0 pg/mL, p < 0.001), IL-8 (27.7 vs. 16.9 pg/ml, p = 0.032),
IL-10 (3.8 pg/mL vs. 1.8 pg/mL, p = 0.005) and ratios of neopterin to
IL-12 (1.74 vs. 0.11, p < 0.001), and IL-10 to IL-12
(0.4 vs. 0.05, p < 0.001) than the non-infection group. After a subdivision
of the study population into patients with local or advanced disease,
the differences between the study groups remained statistically significant for CRP
and neopterin both in local (p < 0.05 and p < 0.001) and advanced diasease
(p < 0.01 and p < 0.001) and in advanced disease for PCT
(p < 0.001), IL-10 (p < 0.05), IL-12 (p < 0.05), neopterin to IL-12 ratio
(p < 0.01) and IL-10 to IL-12 ratio (p < 0.01). The ESR levels did not differ
between the study group (50 vs. 42 p = 0.16), while the IL-12 values were lower
in the infection group (10.6 pg/mL vs. 71.6 pg/mL, p = 0.007). The tumor load did
not influence any of the studied infection markers within the study groups.

For identifying bacteremia by area under the operating characteristics
curves (AUC), the highest values were obtained for PCT (0.92) and
neopterin (0.90), and slightly lower values were recorded for the ratios
neopterin to IL-12 (0.79) and IL-10 to IL-12 (0.75). None of the
markers or ratios were good for differentiating non-bacteremic infections
from neoplastic fever, the AUC values rangin from 0.27 for ESR to
0.61 for IL-10 to IL-12 ratio. The simultaneous use of the ratio of
neopterin to IL-12 with its high sensitivity (82%) and that of IL-10 to
IL-12 with its high specificity (90%) should be further studied.

Identiferoai:union.ndltd.org:oulo.fi/oai:oulu.fi:isbn951-42-5852-5
Date15 December 2000
CreatorsKallio, R. (Raija)
PublisherUniversity of Oulu
Source SetsUniversity of Oulu
LanguageEnglish
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/doctoralThesis, info:eu-repo/semantics/publishedVersion
Formatapplication/pdf
Rightsinfo:eu-repo/semantics/openAccess, © University of Oulu, 2000
Relationinfo:eu-repo/semantics/altIdentifier/pissn/0355-3221, info:eu-repo/semantics/altIdentifier/eissn/1796-2234

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