Procalcitonin, C-reactive protein, and white blood cell count levels in end-stage cancer patients: A retrospective study on inflammatory markers and their prognostic value

Procalcitonin (PCT), C-reactive protein (CRP), and white blood cell count (WBC) are commonly recognized as inflammatory markers. Some studies showed that these markers were also related to some cancers. This study aimed to investigate whether these markers were exhibited aberrations in end-stage cancer patients and to assess their correlation with infection and prognosis. The study underscores the potential of inflammatory markers as prognostic indicators in end-stage cancer, proposing that routine monitoring of these markers could substantially enhance patient management and improve outcomes. The medical records of 116 cancer patients were retrospectively reviewed. Data from end-stage cancer patients were collected during the week preceding their death. The control group consisted of cancer patients with a performance status score of 3 to 4 and clinical stage of III to IV. Normally distributed continuous data (mean ± SD) were analyzed using t-test. Non-normally distributed data (median [M] with interquartile range [P25, P75]) were analyzed using Wilcoxon rank-sum test. Numerical data were subjected to Chi-square test. Logistic regression analysis was employed to assess the correlation between inflammatory markers and patient prognosis. There were significant differences between the 2 groups for PCT, WBC, CRP, platelet count, and body mass index. However, subgroup analysis indicated that there were no significant differences in PCT, CRP, and WBC levels between infected and noninfected patients within the deceased group. It is worth noting that elevated levels of PCT (OR = 7.13, 95% confidence interval [CI] = 1.68-30.36, P = .008) and WBC (OR = 2.47, 95% CI = 1.13-1.13, P = .024) were ultimately identified as independent risk factors associated with poor prognosis in cancer patients, as demonstrated by further logistic regression analysis. In the subgroup analysis of noninfected patients, the univariate analysis revealed that both PCT (OR = 11.612, 95% CI = 1.217-110.776, P = .033) and WBC (OR = 3.077, 95% CI = 1.004-9.427, P = .049) had a statistically significant difference in outcomes between the alive group and the deceased group. The PCT, WBC, and CRP levels of end-stage cancer patients were significantly elevated, regardless of infection. An increase in PCT and WBC was associated with an increased risk of death. These findings suggest that monitoring PCT and WBC levels in end-stage cancer patients may provide valuable prognostic information, aiding in clinical decision-making.