The Role of Procalcitonin in Gynaecological Surgery

Abstract

We evaluated postoperative concentrations of inflammatory indicators, including procalcitonin, after gynaecological operations for benign and malignant tumours in patients with a normal postoperative course and assessed the utility of procalcitonin in differentiating between non-bacterial inflammation and bacteraemic complications in the postoperative period. This prospective study included 99 patients: 47 after a standard gynaecological operation (Piver I) and no postoperative infectious complications (group 1), 35 after a major procedure (Piver II or III) and no postoperative infectious complications (group 2), and five with postoperative sepsis after Piver II or III procedures (group 3). We also studied serum procalcitonin concentrations in a group of 12 patients (group 4) with terminal forms of gynaecological cancer who were hospitalized for palliative treatment but did not undergo surgery. Postoperative C-reactive protein (CRP) concentration corresponded with extent of tissue trauma in groups 1 and 2 and was significantly lower in group 1 than group 2. Inflammatory indicators were highest in groups 1 and 2 on postoperative day 2. In group 3, in which sepsis developed, values were highest on postoperative day 4. In particular, procalcitonin was > 2 ng/ml in all patients with postoperative sepsis by postoperative day 2 but was always <or= 2 ng/ml in patients without sepsis. In contrast, high procalcitonin levels were noted in the patients in group 4 compared with group 3, with two-thirds of group 4 patients having levels > 2 ng/ml, with no signs of infection or raised CRP. It is concluded that, for early detection of postoperative infectious complications after gynaecological surgery, procalcitonin levels > 2 ng/ml are more specific than CRP.

Expression of the nociceptin precursor and nociceptin receptor is modulated in cancer and septic patients

“…30 Increased PCT concentrations in the terminal phase of a malignancy are discussed as a result of local release of inflammatory mediators from the necrotizing tumour. 31 In addition to bacterial toxins, some cytokines like tumour necrosis factor (TNF)-a and IL-6 are able to trigger PCT synthesis. 31 It has to be emphasized that some of the cancer patients might have suffered from a concomitant infection, for example, pneumonia, urological tract infection, resulting in elevated markers of inflammation.…”

“…31 In addition to bacterial toxins, some cytokines like tumour necrosis factor (TNF)-a and IL-6 are able to trigger PCT synthesis. 31 It has to be emphasized that some of the cancer patients might have suffered from a concomitant infection, for example, pneumonia, urological tract infection, resulting in elevated markers of inflammation. However, only one patient was diagnosed with infection.…”

The Utility of Pre-Treatment Inflammation Markers as Associative Factors to the Adverse Outcomes of Vulvar Cancer: A Study on Staging, Nodal Involvement, and Metastasis Models

“…Similar to CRP, few studies highlighted the role of procalcitonin in advanced gynaecological malignancies [119], one of which was a study on ovarian cancer [120]. We discovered that the median value of procalcitonin was more remarkable in advanced-stage VC than in the early stage (0.67 vs. 0.05, p = 0.044).…”

The Role of C-reactive Protein and Procalcitonin in Predicting the Occurrence of Pancreatic Fistula in Patients who Underwent Laparoscopic Pancreaticoduodenectomy: a Retrospective Study

“…PCT is one of the most important variables that enables us to distinguish infection-induced inflammation from non-infection-induced inflammation [26], and it has become widely used as a biomarker for bacterial infection as well as a role in highlighting the effectiveness of antibiotic therapy, in addition to its widespread adoption in intensive care units to monitor and control the severity of sepsis [27]. Several studies have demonstrated that PCT also plays a role in predicting postoperative complications for a variety of operations such as colorectal, cardiac, and gynecological surgeries [17,28,29]. However, due to a lack of studies that have investigated PCT, its importance in pancreatic surgery and in predicting its complications has remained understudied.…”