Evaluation Of Various Biomarkers In Diagnostic And Prognostic Value Of Severe Community Acquired Pneumonia

Objective: To evaluate the value of carcinoembryonic antigen(CEA),ferritin,D-dimer,fibrinogen degradation product(FDP),white blood cell(WBC)and C-reactive protein(CRP)in diagnosis and prognosis of severe community-acquired pneumonia(SCAP).Methods: Prospective observational study:One hundred and seventy-seven patients were divided into 3 groups: severe community-acquired pneumonia group(SCAP)of 61,normal community-acquired pneumonia group(CAP)of 56 and healthy people group(HP)of 60.Initial level of above biomarkers were compared and analyzed in the three groups.Then the efficiency of diagnosing and predicting the outcome of SCAP by single and combined index were evaluated by receiver operating characteristic curve(ROC).Meanwhile patients in SCAP group were divided into two groups according to the CEA level named CEA increasing group and normal group,between which the differences in prognosis and biomarker level were compared.Results: The initial level of all biomarkers increased in two pneumonia groups and exceeded the HP group(P<0.01)while betweenSCAP and CAP groups,all indexes in SCAP group were higher than the CAP group(P<0.001).The areas under the ROC of CEA,ferritin,D-dimer,CRP,WBC and united respectively were 0.800,0.834,0.769,0.898,0.756 and 0.956.The sensitivity of united index was 91.8% while specificity was90.5%.Among SCAP group,only CEA level made sense to predict the prognosis(P<0.01).There were significant differences in intubation rate,mortality,length of RICU stay and FDP,D-dimer between CEA increasing group and normal group(P<0.05).Conclusion: High level CEA,ferritin,d-dimer,CRP and WBC have significant value in diagnosis of severe pneumonia.And the combined index has higher value than single one.Severe pneumonia with CEA level increasing indicates more serious condition and poor prognosis.