Analysis of the relationship between serum amyloid protein A, procalcitonin, C-reactive protein, and peripherally inserted central catheter infection in patients with malignant tumor

Background: Compared with a central venous catheter, a peripherally inserted central catheter (PICC) has the advantages of less trauma and a lower risk of bleeding and bloodstream infection. However, patients with tumors are commonly immunocompromised and therefore susceptible to infection during the course of PICC indwelling. This study aimed to investigate the relationship between serum amyloid protein A (SAA), procalcitonin (PCT), C-reactive protein (CRP), and PICC infection in patients with malignant tumor. Methods: Patients with malignant tumor treated with PICC in Gansu Provincial Cancer Hospital from March 2017 to January 2020 were retrospectively investigated. The incidence of infection and the differences in SAA, PCT, CRP, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIG), interleukin-18 (IL-18), and interleukin-16 (IL-6) between the infected group and noninfected group were observed. The correlations of SAA, PCT, and CRP levels in different infection sites and infection degrees were analyzed. Results: A total of 414 eligible patients were included with 93 in the infection group and 321 in the noninfection group. The overall incidence of infection was 22.4%. The levels of SAA, PCT and CRP in the infection group were significantly higher than those in the noninfection group (P<0.001). Compared with the non-infected group, the levels of PT, APTT, TT, IL-18 and IL-6 were significantly higher in the infected group (P<0.001). However, the level of FIG was significantly lower in the infected group (P<0.001). Compared with the local infection group, the levels of SAA, PCT, and CRP in the bloodstream infection group were significantly higher (P<0.001). Furthermore, the levels of SAA, PCT, and CRP were positively correlated with the degree of PICC catheter infection. Conclusions: In patients with malignant tumors, PICC catheter infection were associated with increased risk of bleeding and the levels of SAA, PCT, and CRP can be used as predictive diagnostic indexes for PICC catheter infection. Furthermore, these parameters were positively correlated with the degree of PICC catheter infection.