배경/목적: 췌장암 환자의 발열 시 세균 감염 여부를 빠르게 감별할 수 있는 지표가 필요하다. 본 연구는 프로칼시토닌의 감염 예측력과 임상적 유용성을 평가하고자 하였다. 방법: 2021년 분당서울대학교병원에서 입원한 췌장암 환자 149명의 199건 발열 에피소드를 후향적으로 분석하였다. 백혈구 수치, C-반응단백, 프로칼시토닌의 감염 예측력을 민감도-특이도 곡선(receiver operating characteristic curve) 분석을 통해 비교하였다. 결과: 프로칼시토닌이 높은 군에서 그람음성균 감염, 양성 혈액 배양률, 발열 이후 입원 기간이 유의하게 높았다. 세 지표의 곡선하면적(area under the curve)은 백혈구 수치 0.550, C-반응 단백 0.580, 프로칼시토닌 0.763으로 나타났다. 결론: 프로칼시토닌은 췌장암 환자의 발열 시 세균 감염 예측에 유용한 보조 지표가 될 수 있다.

Background/Aim: Pyogenic infections are common in pancreatic cancer patients with fever. This study evaluated procalcitonin as a biomarker for bacterial infection in this population. Methods: A retrospective study was conducted at Seoul National University Bundang Hospital on 149 pancreatic cancer patients who experienced 199 febrile episodes during hospitalization in 2021. The diagnostic performance of white blood cell (WBC) count, C-reactive protein (CRP), and procalcitonin was assessed using receiver operating characteristic curve analysis and area under the curve (AUC). Results: Among 199 febrile episodes, 57.3% occurred in patients with metastatic disease. The most common cause of fever was cholangitis (22.6%), followed by pneumonia (10.1%). Positive blood cultures were more frequent in patients with elevated procalcitonin (51.7% vs. 14.9%, p<0.001). Gram-negative infections were more common in the high procalcitonin group, while culture-negative cases predominated in the low group. Procalcitonin showed stronger correlation with CRP (r=0.31) than with WBC (r=0.16). AUCs were 0.550 (WBC), 0.580 (CRP), and 0.763 (procalcitonin). Patients with procalcitonin ≥1.84 ng/mL had longer hospital stays (9.36 vs. 7.37 days; p=0.0266). Conclusions: Procalcitonin showed the highest diagnostic accuracy for bacterial infection in febrile pancreatic cancer patients and may help guide antibiotic decisions.

INTRODUCTION
METHODS
    1. Study population
    2. Definition
    3. Clinical outcomes
    4. Statistics
RESULTS
    1. Comparison of biomarkers for predictingbacterial infection
    2. Correlations between biomarkers
    3. Comparison of baseline characteristics basedon procalcitonin cutoff levels
    4. Causes of fever
    5. Identified bacterial pathogens
DISCUSSION
요 약
ORCID
ETHICAL APPROVAL
REFERENCES

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