ABSTRACT
PURPOSE: The aim of this study was to evaluate the accuracy of serum procalcitonin (PCT) and C-reactive protein (CRP) for early diagnosis of postoperative intra-abdominal infections (PIAI) after elective surgery for colorectal cancer. METHODS: Prospective observational study including patients operated on for colorectal cancer between January and December of 2015 was performed. Serum PCT and CRP levels were measured before surgery and daily until postoperative day 3. RESULTS: One hundred twenty patients were included. Seven patients (5.8%) had PIAI. PCT levels were significantly higher in patients with PIAI on postoperative days 1 and 3, whereas CRP levels only were significantly more elevated on postoperative day 3. The ratio between CRP levels on postoperative day 3 and CRP levels on postoperative days 2 (CRP D3/CRP D2) and 1 (CRP D3/CRP D1) was significantly higher in patients with PIAI. PCT on postoperative day 3, for a cutoff of 0.45 ng/mL, had the best sensitivity (100%) with a specificity of 73.8%. The ratio CRP D3/CRP D1 yielded the higher specificity and positive predictive value (90.9 and 27.3%, respectively, for a cutoff of 1.8). The higher negative predictive value was obtained for PCT on postoperative days 1 and 3 (100%, with cutoff of 0.76 and 0.45 ng/mL, respectively) and for CRP on postoperative day 3 (100% with cutoff of 10 mg/dL). CONCLUSION: PCT and CRP serum levels are associated with the appearance of PIAI after colorectal cancer surgery, although the positive predictive values were low for both PCT and CRP. However, the negative predictive values were high.
Subject(s)
C-Reactive Protein/metabolism , Calcitonin/blood , Colorectal Neoplasms/surgery , Digestive System Surgical Procedures/adverse effects , Intraabdominal Infections/diagnosis , Aged , Aged, 80 and over , Biomarkers/blood , Early Diagnosis , Female , Humans , Intraabdominal Infections/blood , Intraabdominal Infections/etiology , Male , Middle Aged , Predictive Value of Tests , Prospective Studies , Reproducibility of Results , Time Factors , Treatment OutcomeABSTRACT
El carcinoma de células de Merkel es un tumor maligno cutáneo poco frecuente del que han sido descritos unos 500 casos en la literatura médica mundial. Por ser un tumor cutáneo es fácilmente accesible al diagnóstico precoz. Sin embargo, la apariencia que suelen adoptar y el desconocimiento de su existencia pueden inducir a confusión con procesos inflamatorios, retrasándose el diagnóstico y con ello su adecuado tratamiento.En el presente artículo se revisan sus aspectos clínicos e histológicos, así como las modalidades terapéuticas utilizadas y sus resultados (AU)
Subject(s)
Humans , Carcinoma, Merkel Cell/surgery , Carcinoma, Merkel Cell/pathology , Prognosis , Neoplasm StagingABSTRACT
Two cases are presented of papillary-cystic carcinoma of the pancreas diagnosed and treated in the II General Surgery Service of the Gregorio Marañón General Hospital of Madrid (Spain) over the last six years. Both occurred in young women who presented with pain and abdominal mass. The tumors were large and were located on the tail of the pancreas. One was treated by local resection and the other by distal pancreatectomy. Both women are free of disease after a follow-up period of 6 years and 10 months, respectively. This is a very infrequent tumor, about 100 cases having been described up until the present, and it has a very favorable prognosis. Its clinical, diagnostic, pathologic, therapeutic and prognostic features are analyzed.
