C-reactive protein and erythrocyte sedimentation rate in differential diagnosis between infections and neoplastic fever in patients with solid tumours and lymphomas

The goals of our work were to study prospectively the possibility of differ entiating between infections and neoplastic fever in adult cancer patients on admission, by means of C-reactive protein (CRP) and erythrocyte sediment ation rate (ESR) or of follow-up CRP values. Patients and methods were as f ollows: the final infection group consisted of 56 patients and the noninfec tion group of 10 patients with neoplastic fever; CRP was measured on days 0 , 3 and 5 and ESR at entry. The main results showed that the median CRP did not differ between the groups (91 mg/l vs 102 mg/l) on entry, while the ES R level was higher in the neoplastic fever group (50 mm/H vs 89 mm/H, P=0.0 23). On admission, both markers had low area under receiver operating chara cteristic curves for the demonstration of infection (CRP 0.42; ESR 0.27). T he CRP level dropped significantly in the infection group within 5 days (P= 0.009). We conclude that neither of the markers was useful in differentiati ng between infections and neoplastic fever on admission, but that the follo w-up CRP values were advantageous in this respect.