Procalcitonin Level in Non-Small Cell Lung Cancer Patients among Indonesian Population

Abstract

BACKGROUND:Serum Procalcitonin (PCT) is a biomarker that is frequently used to diagnose an infection. In some cases of thoracic malignancy, procalcitonin level appears to increase. However, the role of procalcitonin to diagnose malignancy is not certain yet, and the causes have not been known.AIM:This study aimed to investigate procalcitonin levels in non-small cell lung cancer patients.METHODS:This was an observational study with a cross-sectional design. All lung cancer patients did not diagnose based on cytology/histopathology results with no evidence nor were signs and symptoms of infection recruited through consecutive sampling. The subtypes of lung cancer include adenocarcinoma, squamous cell carcinoma, and large cell carcinoma, staged III and IV. The procalcitonin levels were analysed from blood using immunofluorescent assay. Data were then analysed with the Chi-Square test by Epi Info™ 7 programs in which p-value < 0.05 was considered statistically significant.RESULTS:A total of 68 lung cancer patients fulfilled the criteria of this study, 55 men (80.9%) and 13 women (19.1%). The highest percentage of cytology/histopathology type found was adenocarcinoma (80.9%), and 60.3% of those were diagnosed in stage IV. An increased procalcitonin level (greater than 0.01 ng/mL) occurred in 80.9% of Non-Small Cell Lung Cancer (NSCLC) patients. It appears that the higher the stage of lung cancer, the lower procalcitonin levels would be, although it was not statistically significant. There was no association between lung cancer subtype with procalcitonin levels.CONCLUSION:An increased level of procalcitonin may be an indication not only for infection but also for Non-Small Cell Lung Cancer.

Serum Procalcitonin in Patients With Combined Lung Cancer and Idiopathic Pulmonary Fibrosis (LC-IPF)

“…This difference is closely related to the development of LC in patients with IPF, as the majority (73.3%) of IPF patients developed LC 18.6 ± 15.8 months after the initial diagnosis of their IPF. Our finding is in agreement with many reports that observed that PCT can be elevated due to malignancy [11][12][13][14][21][22]. Ghillani et al found increased calcitonin precursor levels as compared to healthy subjects in 17.5%, 53%, and 29% of patients with squamous cell cancer, large cell cancer, and adenocarcinoma, respectively [21].…”

“…This is the first study that compares the serum levels of the commonly used marker procalcitonin between patients with IPF and those with combined LC-IPF. Previous reports had addressed levels of PCT either in acute exacerbations of interstitial lung disease [ 10 ] or LC alone [ 11 - 13 ], with mixed results. In the current study, we had chosen well-characterized groups of stable IPF alone and LC-IPF patients who had no known factors compromising the evaluation of PCT levels (i.e., infectious, inflammatory, or therapy-induced factors).…”

“…Several studies have demonstrated that PCT is a potential biomarker for sepsis and infection and a guide to antibiotic administration [ 8 - 9 ]. Because of its importance, PCT has been studied in patients with either IPF alone [ 10 ] or LC alone [ 11 - 13 ]. Beyond its role in sepsis and guidance to antibiotic administration, it was observed that PCT has a potential role in predicting cancer in non-febrile patients, and it was useful in predicting the progression of malignancy in non-febrile cancer patients [ 14 ].…”

The Correlation between Hemostatic Parameters and Mortality Rate in Patients with Non-Small Cell Lung Cancer

“…This is in line with Soeroso et al that found the most common NSCLC was adenocarcinoma (80.9%). 15 Along with the course of disease, chemotherapy also increases hypercoagulable state risk, depending on duration and particular agents. Platinum-based chemotherapy, anthracyclines, and nitrogen mustard analogs have an association with venous thromboembolism (VTE) state in various solid tumor malignancy.…”

The application of procalcitonin in respiratory diseases: an evaluation of the current research literature

“…Through the analysis of keywords, the current research hotspots in the field of respiratory diseases appear to be sepsis, pneumonia, and infections. However, according to indepth analysis of the literature, increasingly, more and more studies are examining the relationship between PCT and other diseases of the respiratory system, such as the value of PCT in the diagnosis and prognosis of lung cancer patients (10,11,(21)(22)(23)(24). Studies have shown that even if patients with lung cancer are not co-infected, the average serum PCT levels were higher than that of non-infected patients without lung cancer, and the higher the PCT levels, the worse the prognosis (10,22,23).…”