Procalcitonin Levels in Post TACE Infection

Area of Science:

• Hepatobiliary Surgery
• Oncology
• Infectious Disease Diagnostics

Background:

• Transarterial chemoembolization (TACE) is a standard treatment for hepatocellular carcinoma (HCC).
• Post-TACE complications, including infection and abscess, can significantly impact patient outcomes.
• Accurate and timely diagnosis of these complications is crucial for effective management.

Purpose of the Study:

• To evaluate the diagnostic value of serum procalcitonin (PCT) levels for detecting abscess and sepsis following TACE in HCC patients.
• To determine the sensitivity and specificity of PCT in differentiating infection and abscess subtypes post-TACE.

Main Methods:

• Retrospective chart review of 2221 HCC patients undergoing 8656 TACE procedures.
• Patients categorized into infection (Group A) and abscess (Group B) groups post-TACE.
• Subgroup analysis of abscess patients with (B2) and without (B1) sepsis; comparison of PCT, C-reactive protein (CRP), neutrophil count (NEUT), and neutrophil percentage (NEUTP).

Main Results:

• Mean PCT and CRP levels were elevated in the abscess group (B) compared to the infection group (A).
• Serum PCT levels were significantly higher in patients with both liver abscess and sepsis (B2) versus those with liver abscess alone (B1) (P<0.001).
• Receiver-operating characteristic (ROC) analysis indicated high sensitivity and specificity for PCT in predicting liver abscess with sepsis, with a cutoff of 5.1 ng/mL.

Conclusions:

• Serum procalcitonin (PCT) is a valuable, cost-effective biomarker for diagnosing liver abscess and sepsis after TACE in primary liver cancer patients.
• A PCT cutoff level of 5.1 ng/mL demonstrates high sensitivity and specificity for identifying patients with liver abscess and concurrent sepsis.
• PCT offers a promising tool for early detection and management of post-TACE complications in HCC.