ABSTRAK Latar Belakang: Pengaruh metastasis sebagai penyebab peningkatan procalcitonin(PCT) pada pasien tumor padat nonsepsis masih belum jelas. Studi-studisebelumnya memberikan hasil yang tidak konklusif. Nilai titik potong PCT untukdiagnosis sepsis pada tumor padat metastasis juga belum diketahui. Tujuan: Mengetahui peran PCT dalam diagnosis sepsis pada pasien tumor padatdengan metastasis. Metode: Studi potong lintang terhadap pasien tumor padat yang berobat di RSCMSeptember-Desember 2015. Pada pasien ditentukan ada tidaknya sepsismenggunakan kriteria sepsis ACCP/SCCM 2001, dilakukan pemeriksaan darahperifer, serta PCT. Dilakukan analisis untuk mengetahui perbedaan kadar PCTpasien tumor padat metastasis dan tanpa metastasis yang tidak sepsis. Selain itu,dilakukan pula pencarian nilai titik potong PCT untuk diagnosis sepsis pada pasientumor padat metastasis dengan menggunakan ROC. Hasil dan Pembahasan: Didapatkan 112 pasien tumor padat, pria sebanyak 51%,dengan rerata usia 47,9 ±12,47 tahun. Sebanyak 71 (63,4%) pasien sudahdidapatkan metastasis, 36 (32,1%) diantaranya sepsis, dan 6 (5,3%) mengalamiSIRS. Dari 41 (36,6%) pasien tanpa metastasis, 9 (8%) mengalami sepsis, dan 5(4,4%) SIRS. Terdapat perbedaan bermakna kadar PCT pada pasien tumor padatmetastasis dibandingkan tanpa metastasis pada kondisi nonsepsis [0,25 ng/mL(0,07-1,76) vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Pasien tumor padat metastasisyang mengalami sepsis memiliki kadar PCT lebih tinggi dibandingkan nonsepsis[3,5 ng/mL (0,66-189,4) vs. 0,25 ng/mL (0,07-1,76); p<0,001]. Dari kurva ROCkadar PCT pada tumor padat metastasis, didapatkan AUC [0,956, IK 0,916-0,996]untuk mendiagnosis sepsis. Nilai titik potong PCT untuk diagnosis sepsis padapasien tumor padat metastasis adalah 1,14 ng/mL dengan sensitivitas 86% danspesifisitas 88%. Kesimpulan: Pada kondisi nonsepsis, kadar PCT pasien tumor padat metastasislebih tinggi dibandingkan pasien tanpa metastasis. Nilai titik potong PCT untuk diagnosis sepsis pada tumor padat metastasis adalah 1,14 ng/mL. ABSTRACT Background: The effect of metastasis as a cause of increased procalcitonin (PCT)in patients with solid tumors without sepsis remains unclear. Previous studies didnot provide conclusive results. Cut off point of PCT for sepsis diagnosis inmetastatic solid tumors is also unknown. Objective: To determine the role of PCT in the diagnosis of sepsis towardmetastatic solid tumors patients. Methods: A cross sectional study was conducted in solid tumor patients who wereadmitted to Cipto Mangunkusumo, Jakarta between September 2015 and December2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS inpatients. Procalcitonin level, as well as routine blood examination, was performedto determine the differences of PCT level among solid tumor patients with andwithout metastasis. Cut off point of PCT for diagnosing sepsis in patients withmetastatic solid tumors was determined using ROC curve. Results and Discussion: There were 112 patients with solid tumors, 51% male,with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. Inthe absence of sepsis, the PCT level was significantly higher in patients withmetastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsishad PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsisin metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCTfor sepsis in patients with metastatic solid tumors was 1.14 ng / mL with asensitivity of 86% and specificity of 88%. Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solidtumors is higher than patients without metastasis. Cut off point of PCT for sepsisdiagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)in patients with solid tumors without sepsis remains unclear. Previous studies didnot provide conclusive results. Cut off point of PCT for sepsis diagnosis inmetastatic solid tumors is also unknown. Objective: To determine the role of PCT in the diagnosis of sepsis towardmetastatic solid tumors patients. Methods: A cross sectional study was conducted in solid tumor patients who wereadmitted to Cipto Mangunkusumo, Jakarta between September 2015 and December2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS inpatients. Procalcitonin level, as well as routine blood examination, was performedto determine the differences of PCT level among solid tumor patients with andwithout metastasis. Cut off point of PCT for diagnosing sepsis in patients withmetastatic solid tumors was determined using ROC curve. Results and Discussion: There were 112 patients with solid tumors, 51% male,with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. Inthe absence of sepsis, the PCT level was significantly higher in patients withmetastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsishad PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsisin metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCTfor sepsis in patients with metastatic solid tumors was 1.14 ng / mL with asensitivity of 86% and specificity of 88%. Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solidtumors is higher than patients without metastasis. Cut off point of PCT for sepsisdiagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)in patients with solid tumors without sepsis remains unclear. Previous studies didnot provide conclusive results. Cut off point of PCT for sepsis diagnosis inmetastatic solid tumors is also unknown. Objective: To determine the role of PCT in the diagnosis of sepsis towardmetastatic solid tumors patients. Methods: A cross sectional study was conducted in solid tumor patients who wereadmitted to Cipto Mangunkusumo, Jakarta between September 2015 and December2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS inpatients. Procalcitonin level, as well as routine blood examination, was performedto determine the differences of PCT level among solid tumor patients with andwithout metastasis. Cut off point of PCT for diagnosing sepsis in patients withmetastatic solid tumors was determined using ROC curve. Results and Discussion: There were 112 patients with solid tumors, 51% male,with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. Inthe absence of sepsis, the PCT level was significantly higher in patients withmetastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsishad PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsisin metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCTfor sepsis in patients with metastatic solid tumors was 1.14 ng / mL with asensitivity of 86% and specificity of 88%. Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solidtumors is higher than patients without metastasis. Cut off point of PCT for sepsisdiagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)in patients with solid tumors without sepsis remains unclear. Previous studies didnot provide conclusive results. Cut off point of PCT for sepsis diagnosis inmetastatic solid tumors is also unknown. Objective: To determine the role of PCT in the diagnosis of sepsis towardmetastatic solid tumors patients. Methods: A cross sectional study was conducted in solid tumor patients who wereadmitted to Cipto Mangunkusumo, Jakarta between September 2015 and December2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS inpatients. Procalcitonin level, as well as routine blood examination, was performedto determine the differences of PCT level among solid tumor patients with andwithout metastasis. Cut off point of PCT for diagnosing sepsis in patients withmetastatic solid tumors was determined using ROC curve. Results and Discussion: There were 112 patients with solid tumors, 51% male,with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. Inthe absence of sepsis, the PCT level was significantly higher in patients withmetastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsishad PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsisin metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCTfor sepsis in patients with metastatic solid tumors was 1.14 ng / mL with asensitivity of 86% and specificity of 88%. Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solidtumors is higher than patients without metastasis. Cut off point of PCT for sepsisdiagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)in patients with solid tumors without sepsis remains unclear. Previous studies didnot provide conclusive results. Cut off point of PCT for sepsis diagnosis inmetastatic solid tumors is also unknown. Objective: To determine the role of PCT in the diagnosis of sepsis towardmetastatic solid tumors patients. Methods: A cross sectional study was conducted in solid tumor patients who wereadmitted to Cipto Mangunkusumo, Jakarta between September 2015 and December2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS inpatients. Procalcitonin level, as well as routine blood examination, was performedto determine the differences of PCT level among solid tumor patients with andwithout metastasis. Cut off point of PCT for diagnosing sepsis in patients withmetastatic solid tumors was determined using ROC curve. Results and Discussion: There were 112 patients with solid tumors, 51% male,with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. Inthe absence of sepsis, the PCT level was significantly higher in patients withmetastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsishad PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsisin metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCTfor sepsis in patients with metastatic solid tumors was 1.14 ng / mL with asensitivity of 86% and specificity of 88%. Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solidtumors is higher than patients without metastasis. Cut off point of PCT for sepsisdiagnosis in metastatic solid tumors was 1,14 ng / mL. |