Predictive value of procalcitonin for infection of patients with type-2 diabetes mellitus

An immunogenomic signature for molecular classification in hepatocellular carcinoma

Immunity plays an important role in tumor development. In this study, we aimed to investigate molecular classification and its prognostic value in hepatocellular carcinoma (HCC) based on immune signature. Gene set enrichment analysis (GSEA) was used to calculate scores of immune pathways for HCC and hierarchical clustering in two databases (The Cancer Genome Atlas [TCGA], Liver Cancer-RIKEN, JP [LIRI_JP]). The scores of the immune microenvironment and the proportions of 22 immune cells were also calculated. Single-sample GSEA (ssGSEA) was used to screen survival prognosis-related immune pathways and calculate the hazard radio of differentially expressed immune-related genes (IRGs), which were validated in clinical samples and multiple datasets. Based on the immune characteristics, we identified three HCC subtypes, namely immunity high (Immunity_H), immunity medium (Immunity_M), and immunity low (Immunity_L), and confirmed that the classification was reliable and predictable. Immunity_H with a higher immune and stromal score indicated better survival rate. Cox regression analysis showed that IL18RAP and IL7R were the protective genes. Immune risk score was the independent risk factor of overall survival in HCC patients. These results indicated that immunogenomic classification could distinguish HCC patients with different immune status, which could impact the prognosis of the patients with HCC.

Association of the systemic host immune response with acute hyperglycemia in mechanically ventilated septic patients

Hyperglycemia during sepsis is associated with increased organ dysfunction and higher mortality. The role of the host immune response in development of hyperglycemia during sepsis remains unclear. We performed a retrospective analysis of critically ill adult septic patients requiring mechanical ventilation (n = 153) to study the relationship between hyperglycemia and ten markers of the host injury and immune response measured on the first day of ICU admission (baseline). We determined associations between each biomarker and: (1) glucose, insulin, and c-peptide levels at the time of biomarker collection by Pearson correlation; (2) average glucose and glycemic variability in the first two days of ICU admission by linear regression; and (3) occurrence of hyperglycemia (blood glucose>180mg/dL) by logistic regression. Results were adjusted for age, pre-existing diabetes mellitus, severity of illness, and total insulin and glucocorticoid dose. Baseline plasma levels of ST2 and procalcitonin were positively correlated with average blood glucose and glycemic variability in the first two days of ICU admission in unadjusted and adjusted analyses. Additionally, higher baseline ST2, IL-1ra, procalcitonin, and pentraxin-3 levels were associated with increased risk of hyperglycemia. Our results suggest associations between the host immune response and hyperglycemia in critically ill septic patients particularly implicating the interleukin-1 axis (IL-1ra), the interleukin-33 axis (ST2), and the host response to bacterial infections (procalcitonin, pentraxin-3).

The Relationship between Serum Procalcitonin and Dialysis Adequacy in Peritoneal Dialysis Patients

Background:

To detect the serum procalcitonin (PCT) levels of peritoneal dialysis (PD) patients.

Methods:

We analyzed the relationship between the PCT Level and dialysis adequacy. We studied 120 peritoneal dialysis patients without signs of infection in Affiliated Hangzhou First People’s Hospital and 120 controls from Jan 2014 to Apr 2016. PCT and high sensitivity C-reactive protein (hs-CRP) were detected. 120 PD patients were divided into two groups according to the dialysis adequacy. A correlation analysis was processed between the PCT level and the total solute clearance (Kt/V). The value of PCT for identifying the dialysis adequacy in PD patients was assessed by ROC curve analysis.

Results:

PCT level in serum of PD group (0.29±0.24 ng/ml) was higher than that of the control group (0.02±0.01 ng/ml) (P<0.01). Compared with the inadequate dialysis group (0.5±0.37 ng/ml), the PCT Level of the adequate dialysis group (0.23±0.15 ng/ml) was lower (P<0.01). There were negative correlations between PCT and Kt/v(r=−0.451), Prealbumin (PA) (r=−0.258), Glomerular Filtration Rate (eGFR; r=−0.280), while there was positive correlation between PCT and Hypersensitive c-reactive protein (r=0.458) (P<0.01). At a serum PCT cut-off value of 0.283 ng/ml, the sensitivity and specificity for identifying the dialysis adequacy in PD patients were 0.913 and 0.805 respectively. The serum levels of PCT in peritoneal dialysis patients were significantly higher than the levels in healthy controls.

Conclusion:

The serum level of PCT can be used as an indirect maker to evaluate the adequacy of dialysis.

Clinical utility of procalcitonin in severe odontogenic maxillofacial infection

BACKGROUND

Most of the maxillofacial infections are bacterial infections, and there is a possibility that systemic infections occur by maxillofacial infections. The aim of this study was to investigate the diagnostic value of procalcitonin in patients with odontogenic bacterial infections of the maxillofacial region.

METHODS

We enrolled sixty patients, who were admitted with odontogenic maxillofacial infection from September 2018 to March 2020. White blood cell counts, C-reactive protein, and procalcitonin concentrations were evaluated. Sixty patients were classified into two groups, sepsis and non-sepsis groups, based on systemic inflammatory response syndrome. A Student t test was performed to statistically analyze the difference in inflammatory markers between sepsis and non-sepsis groups.

RESULTS

The mean procalcitonin values on admission were 7.24 ng/mL (range, 0.09-37.15 ng/mL) and 0.40 ng/mL (range, 0.02-4.94 ng/mL) in the sepsis group and non-sepsis group, respectively. The procalcitonin values between the two groups showed a significant difference (P < 0.05). The area under the curve of procalcitonin was 0.927 (P < 0.001), and the cutoff value of procalcitonin that maximizes the area under the curve was calculated to be 0.87 ng/mL.

CONCLUSIONS

According to our study, routine laboratory tests have insufficient accuracy in diagnosing sepsis syndrome. Therefore, it is strongly recommended to perform the procalcitonin test in patients with maxillofacial infection in addition to the conventional laboratory tests to diagnose the systemic inflammatory condition of the patients.