Fever and solid tumour: diagnostic utility of procalcitonin and C-reactive protein

Purpose. - Evaluate the clinical utility of procalcitonin (PCT) and C-reactive protein (CRP) as diagnostic of paraneoplastic fever. Method. - A prospective analysis of serum levels of PCT and CRP has been conducted on 68 consecutive febrile patients with solid tumour and no neutropenia. The samples were collected at hospital admission. Results. - Out of 68 patients, 57 had head and neck cancer. Forty-three patients had signs of infection and 19 had paraneoplastic fever. CRP was not significantly different between the two groups (infected patients., median: 134 mg/L, extremes: 20-569, paraneoplastic fever patients: median: 154 mg/L, extremes: 26-267; P = 0.75 with Mann-Whitney test), On the other hand PCT was significantly higher in case of infection (median: 0.44 ng/mL, extremes: 0.09-57.4) than in the case of paraneoplastic fever (median: 0.26 ng/mL, extremes: 0.05-1.17; P = 0.01 with Mann-Whitney test). Conclusion. - In our study, no paraneoplastic fever patient had PCT level equal or above 2 ng/mL (negative predictive value of 100%). (C) 2001 Editions scientifiques et medicales Elsevier SAS.