C-reactive protein, procalcitonin and interleukin-8 in the primary diagnosis of infections in cancer patients

The diagnostic utility of C-reactive protein (CRP), procalcitonin (PCT) and interleukin-8 (IL-8) were studied in 66 cancer patients with suspected inf ection (39 with definite foci of infection, 17 with antibiotic responses wi thout foci and 10 with neoplastic fever without infection) and 26 patients scheduled for chemotherapy. The infection group (n = 56) had higher median CRP (91 versus 19 mg/l, P < 0.001), PCT (0.28 versus 0.12 ng/ml, P < 0.001) and IL-8 values (27.7 versus 16.9 pg/ml, P = 0.032) than the noninfection group (n = 36). In patients with suspected infection, only PCT was a good m arker to discriminate bacteraemia with an area under the receiver operating characteristics curve of 0.92 (95% confidence interval (CI), 0.77-1.0), bu t even PCT was less well able to differentiate between non-bacteraemic infe ctions and neoplastic fever (0.56; 95% CI, 0.35-0.77). In conclusion, PCT w as a good indicator for bacteraemia, but none of the three markers were rel iable indicators for minor infections in non-neutropenic cancer patients. ( C) 2000 Elsevier Science Ltd. All rights reserved.