The role of serum procalcitonin and C-reactive protein levels in predicting spontaneous bacterial peritonitis in patients with advanced liver cirrhosis

Objective: To determine the role of serum procalcitonin (PCT) and C-reactive protein (CRP) in predicting spontaneous bacterial peritonitis (SBP) in patients with advanced liver cirrhosis. Methods: A total of 88 patients with advanced liver cirrhosis were enrolled for this study, which included 40 cases with SBP and 48 cases with CNNA. Bacterial cultures, ascitic fluid (AF) leukocyte, C-reactive protein (CRP) and serum PCT measurements were carried out prior to the use of antibiotics. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of procalcitonin levels. Results: Serum PCT levels in advanced liver cirrhotic patients with SBP were significantly higher than those with CNNA. We used PCT 0.78 ng/mL as optimal cutoff value to diagnose SBP, for which the sensitivity and specificity was 77.5% and 60.4%. The area under the curve (AUC) was 0.706 (95% confidence interval: 0.576- 0.798). The PCT level was significantly correlated with the AF WBC count (rs=0.404, P<0.01). However, there was no significant difference between SBP and CNNA patients in serum CRP levels. Conclusion: According to our findings, serum PCT levels seem to provide an early diagnostic accuracy in advanced liver cirrhotic patients with SBP.