The role of procalcitonin in differential diagnosis between acute radiation pneumonitis and bacterial pneumonia in lung cancer patients receiving thoracic radiotherapy.

Acute Radiation Pneumonitis is one of the most common dose-limiting toxicities of thoracic radiotherapy. The accurate diagnosis of remains a challenge because of the lack of a rapid biomarker capable of differentiating duanyu37 from bacterial pneumo (BP). The aim of this study was to investigate the potential usefulness of procalcitonin (PCT) in the differential diagnosis of duanyu37 and BP. Lung cancer patients who had undergone thoracic radiotherapy within 6 months and were admitted to hospital for duanyu37 or BP were retrospectively analyzed. The serum levels of PCT, C-reactive protein (CRP) and white blood cells (WBC) were compared between the two groups. Receiver operating characteristic (ROC) curve was used to assess the diagnostic value of PCT, CRP and WBC in the differential diagnosis of duanyu37 and BP and determine the best cut-off values. One hundred eighteen patients were included. Among them, seventy-seven patients were diagnosed with and 41 patients were diagnosed with BP. The PCT concentrations for patients diagnosed with duanyu37 group were significantly lower than those in the BP group (P < 0.001). There were no differences in CRP and WBC between the two groups. The areas under the ROC curves (AUC) for PCT, CRP and WBC were 0.745, 0.589 and 0.578, respectively. The best cutoff values of PCT, CRP and WBC were 0.47 μg/L, 54.5 mg/L and 9.9 × 10⁹/L, respectively. Low serum PCT levels are associated with PCT is a useful biomarker to distinguish duanyu37 from BP.

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