Predictive Value of Procalcitonin for Bacterial Infection after Hepatocellular Carcinoma Ablation Therapy

Abstract

Background: The most globally used primary treatments for un-resectable hepatocellular carcinoma (HCC) are trans-arterial chemoembolization (TACE), percutaneous ethanol injection (PET) and radiofrequency ablation (RFA)

Objectives: determine the role of procalcitonin to predict bacterial infection and correspondingly the usefulness of antibiotic use in HCC patients who develop fever after TACE, PET or RFA.

 Patients and methods: This cross section study conducted at Interventional     ultrasound unit Tropical Medicine Department and Radiology Department, Zagazig University Hospitals at period of time from November 2019 to December 2021.

Full history taking, clinical examination, CBC, liver biochemistry (S. bilirubin, ALT, AST, total protein and S. albumin), coagulation profile (PT, INR), kidney function (S. creatinine, blood urea), C-reactive protein (CRP), serum procalcitonine and blood culture was done for all participant at 4 days follow up after the procedures.

Results: 24 of 100 patients had abnormal procalcitonin level. There is highly statistically significant increase of procalcitonin level in patients with high CRP count and positive blood culture, P<0.05. There is statistically significant increased level of procalcitonin with positive correlation between procalcitonin level and levels of CRP, WBCs, Albumin, AST, ALT, Degree of fever, Creatinine and BUN. There is no statistically significant difference of blood culture results in relation to the child score of the patients. 

Conclusion:  bacterial infection mostly not the causative agent of fever in HCC patient after ablation therapy, it may be due to underlying extensive necrosis of the tumor and healthy cells.