降钙素原在肿瘤学中的测定——结果与展望:文献综述

T. Sadykova, M. Kuzikeev, B. Sarsembaev, E. Orazbek
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引用次数: 0

摘要

相关性:对复杂病程的实验室诊断的现代要求要求使用特定的和高科技的研究方法,如测定降钙素原(PCT)水平。PCT水平仅随着细菌感染的普遍化而增加,并反映了抽象程度。具有实用价值的是PCT水平的增加和这种增加的程度,渐进式增加或长期(超过3-5天)高水平。随着时间的推移对这些数据的评估,结合其他临床和实验室参数的变化,可以及时诊断和预测疾病的结果。本研究旨在评估PCT水平动态控制的可行性,以及时诊断癌症患者脓毒性并发症形式的感染过程的叠加或推广。方法:在恶性肿瘤杂志和Cochrane、PubMed、Oncology.ru、library.ru、Medscape和NCBI数据库和图书馆中进行主题性检索。我们分析了肿瘤患者PCT动态变化的研究结果,这些患者以脓毒症并发症的形式发展并普遍化了非特异性感染过程。结果:多篇研究论文均证实有必要确定PCT水平并将其纳入诊断算法。这些研究的可靠性和重要性符合循证医学的最高水平。与其他肿瘤病理指标(如白细胞水平、CRP水平等)相比,PCT在识别感染性成分方面具有很高的特异性。在某些肿瘤过程中,PCT的初始水平可能高于平均值(0.5 ng/l)。然而,动态控制将显示所采取的治疗措施的有效性和感染过程的发展方向。确定PCT级别的频率和间隔特别重要。在某些情况下,如果在危险人群中怀疑存在感染成分,PCT水平的确定可包括在初始检查算法中。结论:尽管PCT研究结果在肿瘤实践中存在歧义,但在复杂的抗肿瘤治疗中,测定全身炎症生物标志物将有助于及时确定处方或加强抗生素治疗的适应症,预测持续时间,并监测其在肿瘤患者中的有效性。
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PROCALCITONIN DETERMINATION IN ONCOLOGY – RESULTS AND PROSPECTS: A LITERATURE REVIEW
Relevance: Modern requirements for laboratory diagnostics of complicated courses of diseases provide for using particular and hightech research methods like determining the level of procalcitonin (PCT). The PCT level increases only with the generalization of a bacterial infection and reflects the degree of abstraction. Of practical value are an increase in the PCT level and the degree of such increase, a progressive increase, or a long-term (more than 3-5 days) high level. The assessment of this data over time, in combination with the changes in other clinical and laboratory parameters, allows for timely diagnosis and prediction of the outcome of the disease. The study aimed to assess the feasibility of the PCT level dynamic control for timely diagnosis of the overlay or generalization of an infectious process in the form of septic complications in cancer patients. Methods: A thematic search was carried out by keywords in the journal Malignant Tumors and Cochrane, PubMed, Oncology.ru, elibrary.ru, Medscape, and NCBI databases and libraries. We analyzed the results of studies of changes in PCT dynamics in oncological patients who developed and generalized a nonspecific infectious process that proceeded in the form of septic complications. Results: Various research papers have confirmed the need to determine the PCT level and its inclusion in the diagnostic algorithms. The reliability and significance of these studies correspond to the highest levels of evidence-based medicine. PCT shows its high specificity in identifying the infectious component compared to other less informative indicators in oncological pathologies, such as the level of leukocytosis, CRP, and others. In some tumor processes, the initial level of PCT may be higher than the average (0.5 ng/l). Still, dynamic control will show the effectiveness of the therapeutic measures taken and the direction of development of the infectious process. The frequency and intervals of determining the PCT level are of particular importance. In some instances, if an infectious component is suspected in risk groups, the PCT level determination could be included in the initial examination algorithm. Conclusion: Despite the ambiguity of the PCT study results in oncological practice, the determination of systemic inflammation biomarkers in complex antitumor therapy will allow timely setting of indications for prescribing or intensifying antibiotic treatment, predicting the duration, and monitoring its effectiveness in oncological patients.
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