Home Medicine Serum procalcitonin concentration within 2 days postoperatively accurately predicts outcome after liver resection
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Serum procalcitonin concentration within 2 days postoperatively accurately predicts outcome after liver resection

  • Yuto Aoki ORCID logo EMAIL logo , Nobuhiko Taniai , Masato Yoshioka , Youichi Kawano , Tetsuya Shimizu , Tomohiro Kanda , Ryota Kondo , Yohei Kaneya , Hiroyasu Furuki and Eiji Uchida
Published/Copyright: April 12, 2018
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 56 Issue 8

Abstract

Background:

Relatively high mortality and morbidity rates are reported after liver resection (LR). However, the early predictors of complications after LR are not clear. This study was performed to clarify the usefulness of procalcitonin (PCT) for the early prediction of complications after elective LR.

Methods:

This observational study included 72 consecutive patients who underwent elective LR from December 2015 to March 2017. Patients were categorized into two groups: those with and without postoperative complications (Clavien-Dindo grade ≥II). The values of postoperative inflammatory markers (white blood cell [WBC] count, C-reactive protein [CRP] and PCT) were compared between the two groups.

Results:

CRP and PCT were significantly higher in patients with than without complications; however, the WBC count showed no difference within 5 days postoperatively. The maximum area under the receiver operating characteristic curves within 2 days after LR using the WBC count, CRP and PCT were 0.608, 0.697 and 0.860, respectively, PCT had the best predictive ability in the early postoperative period. The PCT level peaked within 2 days postoperatively in 61 patients (85%). The maximum PCT level within 2 days postoperatively (PCT1−2) was significantly higher in patients with than without complications (0.52 vs. 0.19 ng/mL, p<0.001). A cutoff PCT1−2 level of 0.35 ng/mL achieved 80% sensitivity and 83% specificity. In patients without complications, there was no difference in PCT1−2 even when the surgical procedure differed (p=0.935).

Conclusions:

PCT1−2 is an early predictive marker after LR and can be similarly used regardless of the LR procedure.

Keywords: complication; early prediction; liver resection; prediction marker; procalcitonin
Corresponding author: Yuto Aoki, MD, PhD, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan, Phone: +81-3-3822-2131, Fax: +81-3-5685-0989

Acknowledgments

We thank Angela Morben, DVM, ELS, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

  1. Author contributions: YA – Study design, data collection, data analysis, writing first draft of manuscript, critical revisions, approved final version. NT – Study design, data analysis, approved final version. MY – Study design, data collection, data analysis, approved final version. YKaw – Study design, data analysis, approved final version. TS – Study design, data collection, data analysis, approved final version. TK – Data analysis, approved final version. RK – Study design, data collection, data analysis, approved final version. YKan – Study design, data collection, data analysis, approved final version. HF – Data analysis, approved final version. EU – Study design, critical revisions, approved final version. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: Nobuhiko Taniai received grants from Teijin Pharma Limited for research for liver transplantation; these grants were outside the scope of this work.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplementary Material:

The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2018-0196).

Received: 2018-01-10
Accepted: 2018-02-27
Published Online: 2018-04-12
Published in Print: 2018-07-26

©2018 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. Procalcitonin for diagnosing and monitoring bacterial infections: for or against?
  4. Is it time to abandon the Nobel Prize?
  5. In Memoriam
  6. Norbert Tietz, 13th November 1926–23rd May 2018
  7. Reviews
  8. Procalcitonin guidance in patients with lower respiratory tract infections: a systematic review and meta-analysis
  9. Telomere biology and age-related diseases
  10. Opinion Paper
  11. Procalcitonin-guided antibiotic therapy: an expert consensus
  12. Genetics and Molecular Diagnostics
  13. mRNA expression profile in peripheral blood mononuclear cells based on ADRB1 Ser49Gly and Arg389Gly polymorphisms in essential hypertension — a case-control pilot investigation in South Indian population
  14. General Clinical Chemistry and Laboratory Medicine
  15. External quality assessment schemes for glucose measurements in Germany: factors for successful participation, analytical performance and medical impact
  16. Long-term stability of glucose: glycolysis inhibitor vs. gel barrier tubes
  17. Observational studies on macroprolactin in a routine clinical laboratory
  18. Anti-streptavidin IgG antibody interference in anti-cyclic citrullinated peptide (CCP) IgG antibody assays is a rare but important cause of false-positive anti-CCP results
  19. Point-of-care creatinine testing for kidney function measurement prior to contrast-enhanced diagnostic imaging: evaluation of the performance of three systems for clinical utility
  20. Hematology and Coagulation
  21. Analytical performance of an automated volumetric flow cytometer for quantitation of T, B and natural killer lymphocytes
  22. Lupus anticoagulant testing using two parallel methods detects additional cases and predicts persistent positivity
  23. Reference Values and Biological Variations
  24. Within-subject biological variation of activated partial thromboplastin time, prothrombin time, fibrinogen, factor VIII and von Willebrand factor in pregnant women
  25. Within-subject and between-subject biological variation estimates of 21 hematological parameters in 30 healthy subjects
  26. Immunoglobulin G (IgG) and IgG subclass reference intervals in children, using Optilite® reagents
  27. Cancer Diagnostics
  28. Serum carbohydrate sulfotransferase 7 in lung cancer and non-malignant pulmonary inflammations
  29. Cardiovascular Diseases
  30. Clinical performance of a new point-of-care cardiac troponin I test
  31. Diabetes
  32. Testing for HbA1c, in addition to the oral glucose tolerance test, in screening for abnormal glucose regulation helps to reveal patients with early β-cell function impairment
  33. Effects of common hemoglobin variants on HbA1c measurements in China: results for α- and β-globin variants measured by six methods
  34. Infectious Diseases
  35. Serum procalcitonin concentration within 2 days postoperatively accurately predicts outcome after liver resection
  36. Predictive value of serum gelsolin and Gc globulin in sepsis – a pilot study
  37. Cerebrospinal fluid free light chains as diagnostic biomarker in neuroborreliosis
  38. Letter to the Editor
  39. Glucose and total protein: unacceptable interference on Jaffe creatinine assays in patients
  40. Interference of glucose and total protein on Jaffe-based creatinine methods: mind the covolume
  41. Interference of glucose and total protein on Jaffe based creatinine methods: mind the covolume – reply
  42. Measuring procalcitonin to overcome heterophilic-antibody-induced spurious hypercalcitoninemia
  43. Paraprotein interference in the diagnosis of hepatitis C infection
  44. Timeo apis mellifera and dona ferens: bee sting-induced Kounis syndrome
  45. Bacterial contamination of reusable venipuncture tourniquets in tertiary-care hospital
  46. Detection of EDTA-induced pseudo-leukopenia using automated hematology analyzer with VCS technology
  47. Early adjustment of antimicrobial therapy after PCR/electrospray ionization mass spectrometry-based pathogen detection in critically ill patients with suspected sepsis
  48. Thromboelastometry reveals similar hemostatic properties of purified fibrinogen and a mixture of purified cryoprecipitate protein components
  49. Bicarbonate interference on cobas 6000 c501 chloride ion-selective electrodes
https://doi.org/10.1515/cclm-2018-0196
Keywords for this article
complication; early prediction; liver resection; prediction marker; procalcitonin

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. Procalcitonin for diagnosing and monitoring bacterial infections: for or against?
  4. Is it time to abandon the Nobel Prize?
  5. In Memoriam
  6. Norbert Tietz, 13th November 1926–23rd May 2018
  7. Reviews
  8. Procalcitonin guidance in patients with lower respiratory tract infections: a systematic review and meta-analysis
  9. Telomere biology and age-related diseases
  10. Opinion Paper
  11. Procalcitonin-guided antibiotic therapy: an expert consensus
  12. Genetics and Molecular Diagnostics
  13. mRNA expression profile in peripheral blood mononuclear cells based on ADRB1 Ser49Gly and Arg389Gly polymorphisms in essential hypertension — a case-control pilot investigation in South Indian population
  14. General Clinical Chemistry and Laboratory Medicine
  15. External quality assessment schemes for glucose measurements in Germany: factors for successful participation, analytical performance and medical impact
  16. Long-term stability of glucose: glycolysis inhibitor vs. gel barrier tubes
  17. Observational studies on macroprolactin in a routine clinical laboratory
  18. Anti-streptavidin IgG antibody interference in anti-cyclic citrullinated peptide (CCP) IgG antibody assays is a rare but important cause of false-positive anti-CCP results
  19. Point-of-care creatinine testing for kidney function measurement prior to contrast-enhanced diagnostic imaging: evaluation of the performance of three systems for clinical utility
  20. Hematology and Coagulation
  21. Analytical performance of an automated volumetric flow cytometer for quantitation of T, B and natural killer lymphocytes
  22. Lupus anticoagulant testing using two parallel methods detects additional cases and predicts persistent positivity
  23. Reference Values and Biological Variations
  24. Within-subject biological variation of activated partial thromboplastin time, prothrombin time, fibrinogen, factor VIII and von Willebrand factor in pregnant women
  25. Within-subject and between-subject biological variation estimates of 21 hematological parameters in 30 healthy subjects
  26. Immunoglobulin G (IgG) and IgG subclass reference intervals in children, using Optilite® reagents
  27. Cancer Diagnostics
  28. Serum carbohydrate sulfotransferase 7 in lung cancer and non-malignant pulmonary inflammations
  29. Cardiovascular Diseases
  30. Clinical performance of a new point-of-care cardiac troponin I test
  31. Diabetes
  32. Testing for HbA1c, in addition to the oral glucose tolerance test, in screening for abnormal glucose regulation helps to reveal patients with early β-cell function impairment
  33. Effects of common hemoglobin variants on HbA1c measurements in China: results for α- and β-globin variants measured by six methods
  34. Infectious Diseases
  35. Serum procalcitonin concentration within 2 days postoperatively accurately predicts outcome after liver resection
  36. Predictive value of serum gelsolin and Gc globulin in sepsis – a pilot study
  37. Cerebrospinal fluid free light chains as diagnostic biomarker in neuroborreliosis
  38. Letter to the Editor
  39. Glucose and total protein: unacceptable interference on Jaffe creatinine assays in patients
  40. Interference of glucose and total protein on Jaffe-based creatinine methods: mind the covolume
  41. Interference of glucose and total protein on Jaffe based creatinine methods: mind the covolume – reply
  42. Measuring procalcitonin to overcome heterophilic-antibody-induced spurious hypercalcitoninemia
  43. Paraprotein interference in the diagnosis of hepatitis C infection
  44. Timeo apis mellifera and dona ferens: bee sting-induced Kounis syndrome
  45. Bacterial contamination of reusable venipuncture tourniquets in tertiary-care hospital
  46. Detection of EDTA-induced pseudo-leukopenia using automated hematology analyzer with VCS technology
  47. Early adjustment of antimicrobial therapy after PCR/electrospray ionization mass spectrometry-based pathogen detection in critically ill patients with suspected sepsis
  48. Thromboelastometry reveals similar hemostatic properties of purified fibrinogen and a mixture of purified cryoprecipitate protein components
  49. Bicarbonate interference on cobas 6000 c501 chloride ion-selective electrodes
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