Predictive value of serum procalcitonin for biliary tract infection of patients with obstruction of biliary tract

doi:10.3877/cma.j.issn.1674-1358.2019.03.013

Abstract

Abstract:

Objective

To investigate the clinical significance of procalcitonin (PCT) for patients with obstruction and early infection of biliary tract.

Methods

From August 2015 to July 2016, a total of 63 patients with obstruction of biliary tract were treated surgically in Huaxi Hospital of Sichuan University. According to bile culture and symptoms after operation, 63 cases were divided into non-infection group (24 cases) and infection group (39 cases). The count of white blood cell (WBC), neutrophil ratio (NE%), PCT level of patients in the two groups were compared, respectively. The diagnostic value of PCT, WBC and NE% for infection of biliary tract were analyzed, including the area under ROC curve, sensitivity, specificity and Yoden index, while the changes of PCT, WBC and NE% of patients in infection group before and after operation were analyzed, respectively.

Results

PCT, WBC and NE% of patients in infection group were significantly higher than those in non-infection group [(1.35 ± 0.15) ng/ml, (9.48 ± 1.17) × 10⁹/L, (79.24 ± 7.83) vs. (0.16 ± 0.04) ng/ml, (8.14 ± 0.87) × 10⁹/L, (67.93 ± 6.09)], with significant differences (t = 37.936, 4.841, 6.035; all P < 0.001). The area under ROC curve of PCT, WBC and NE% of patients in infection group were 0.904, 0.568 and 0.519, respectively. The sensitivity, specificity and Yoden index of PCT were significantly higher than those of WBC and NE%. The levels of PCT, WBC and NE% of patients in infection group 3 days after operation were significantly lower than those before operation [(2.63 ± 0.21) ng/ml, (10.27 ± 1.35) × 10⁹/L, (79.96 ± 7.23) vs. (0.86 ± 0.09) ng/ml, (8.23 ± 0.97) × 10⁹/L, (71.11 ± 6.36)], with significant differences (t = 39.049, 6.442, 4.933; all P < 0.001).

Conclusion

PCT has high diagnostic value for early bile duct infection of patients with obstruction, with significant sensitivity and specificity.

Key words: Infection of biliary tract, Obstruction of biliary tract, Procalcitonin

Wei Li, Xiaodan Ren, Qian He, Rongxing Zhou. Predictive value of serum procalcitonin for biliary tract infection of patients with obstruction of biliary tract[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2019, 13(03): 245-249.

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组别	例数	性别（男/女，例）	平均年龄（±s，岁）	梗阻部位（高位/低位，例）
感染组	39	23/16	68.98 ± 4.52	21/18
非感染组	24	14/10	67.21 ± 4.31	13/11
统计量	?	χ²= 0.002	t= 1.536	χ²= 0.001
P值	?	0.960	0.129	0.980

组别	例数	性别（男/女，例）	平均年龄（±s，岁）	梗阻部位（高位/低位，例）
感染组	39	23/16	68.98 ± 4.52	21/18
非感染组	24	14/10	67.21 ± 4.31	13/11
统计量	?	χ²= 0.002	t= 1.536	χ²= 0.001
P值	?	0.960	0.129	0.980

组别	例数	PCT（ng/ml）	WBC（× 10⁹/L）	NE%
感染组	39	1.37 ± 0.12	9.73 ± 1.03	79.24 ± 7.83
非感染组	24	0.16 ± 0.04	8.11 ± 0.51	67.93 ± 6.09
t值	?	37.936	4.841	6.035
P值	?	<0.001	<0.001	<0.001

组别	例数	PCT（ng/ml）	WBC（× 10⁹/L）	NE%
感染组	39	1.37 ± 0.12	9.73 ± 1.03	79.24 ± 7.83
非感染组	24	0.16 ± 0.04	8.11 ± 0.51	67.93 ± 6.09
t值	?	37.936	4.841	6.035
P值	?	<0.001	<0.001	<0.001

指标	曲线下面积（95%CI）	敏感度	特异性	约登指数
PCT	0.904（0.830～0.979）	0.917	0.795	0.712
WBC	0.568（0.420～0.717）	0.708	0.462	0.17
NE%	0.519（0.372～0.665）	0.875	0.205	0.08

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