Procalcitonin as preoperative marker for surgery in advanced parapneumonic empyema

Abstract

Background: The optimal time point for surgical management of advanced parapneumonic empyema in need of open pleurectomy and decortication remains unclear. We hypothesized that surgical outcomes will be better when procalcitonin (PCT) levels have dropped to normal ranges as evidence for resolution of the underlying pneumonia. Results for postoperative length of stay were similar. Eight patients in the pPCT ≥0.25 μg/L group had postoperative complications with two deaths while no complications occurred in the PCT <0.25 μg/L group (38% vs. 0%, P=0.004).Conclusions: These data suggest better surgical outcomes in advanced parapneumonic empyema when pneumonia has resolved with a pPCT drop of <0.25 μg/L. A larger, prospective study is needed to confirm these results.

Pleural Space Infections

“…Pleural procalcitonin levels > 0.25 ng/mL specifically were noted to have a sensitivity of 77.78% and a specificity of 74.14% for distinguishing infectious pleural effusion from non-infectious pleural effusion [ 41 ]. Additionally, pleural procalcitonin at a level > 0.25 ng/mL was associated with a longer total length of hospital stay (17.0 vs. 8.7 days, 95% CI: −12.5 to −4.0, p < 0.001) and a higher rate of complication (38% vs. 0%, p = 0.004) in a retrospective analysis of 38 patients who received surgery for complicated pleural space infections [ 42 ]. Pleural fluid calprotectin levels have also been studied in exudative pleural effusions and have specifically been noted to be significantly lower in exudative pleural effusions secondary to malignancy as compared with exudative effusions caused by infection [ 43 ].…”

The screening, identification, design and clinical application of tumor-specific neoantigens for TCR-T cells

“…In addition, other nonmutated tumor epitopes of TEIPP, including calcitonin (pCT) precursor proteins (ppCT50-59 and ppCT91-100) and procalcitonin (ppCT) (ppCT16-25, ppCT9-17), have been identified. These antigenic peptides based on TEIPP can effectively induce antitumor CTL effects and inhibit tumor growth [ 100 , 101 ]. Therefore, targeting these TEIPP neoantigens has the potential to provide a promising new immunotherapy approach for TAP-deficient/HLA-low tumors.…”