1. Utility of Procalcitonin concentration in the evaluation of patients with malignant diseases and elevated c- reactive protein plasma concentration Silke Schuttrumpf, Lutz Binder, Thorsten Hagemann, Dinko Berkovic, Lorenz Trumper, and Claudia Binder R1 송세빈 Clinical infectious diseases 2006; 43:468~473

2. Background C-reactive protein  Sensitive marker of acute phase reactions  Elevated in bacterial and fungal infection, active RA, Crohn disease, myocardial infarction and major surgery  Limited in discrimination between infectious and sterile inflammations Acute phase reaction in malignant disease  In many case, Bacterial, viral, fungal infection  Unexplained fever(especially in neutropenia pts)  Administration of drugs and blood products  Malignacy itself in bulky solid organ ca. and advanced lymphoma

3. Procalcitonin(PCT) concentration  Production as part of systemic response to circulating endotoxins and cytokines during bacterial and fungal infections  Correlate with the severity of the infection  Higher in Pts. with systemic bacterial infection than in Pts. With a localized bacterial or viral infection  Discrimination between transplant rejection and infection in organ recipients  hemato-oncological conditions with neutropenia and infection

4. Patients and methods

5. Microbiologically proven infection Clinically defined infection Unexplained fever Drug reaction Tumor associated sterile inflammations classified

6. Result

7. PCT and CRP conc.

8. PCT in various subgroups

9. CRP in various subgroups

10. PRC and CRP difference with/without leukopenia

11. Charecteristic curves for PCT and CRP

12. Sensitivity and specificity

13. conclusion

14. PCT is a valuable parameter for the differential diagnosis for elevated CRP in patients with malignant diseases Delay of chemotherapy is unnecessary