Fever and solid tumour: diagnostic utility of procalcitonin and C-reactiveprotein

Purpose. - Evaluate the clinical utility of procalcitonin (PCT) and C-react ive protein (CRP) as diagnostic of paraneoplastic fever. Method. - A prospective analysis of serum levels of PCT and CRP has been co nducted on 68 consecutive febrile patients with solid tumour and no neutrop enia. The samples were collected at hospital admission. Results. - Out of 68 patients, 57 had head and neck cancer. Forty-three pat ients had signs of infection and 19 had paraneoplastic fever. CRP was not s ignificantly different between the two groups (infected patients., median: 134 mg/L, extremes: 20-569, paraneoplastic fever patients: median: 154 mg/L , extremes: 26-267; P = 0.75 with Mann-Whitney test), On the other hand PCT was significantly higher in case of infection (median: 0.44 ng/mL, extreme s: 0.09-57.4) than in the case of paraneoplastic fever (median: 0.26 ng/mL, extremes: 0.05-1.17; P = 0.01 with Mann-Whitney test). Conclusion. - In our study, no paraneoplastic fever patient had PCT level e qual or above 2 ng/mL (negative predictive value of 100%). (C) 2001 Edition s scientifiques et medicales Elsevier SAS.