Objectives. The aim of this prospective study was to investigate the role of procalcitonin as an early diagnostic marker of pharyngocutaneous fistula (PCF) in a cohort of head and neck patients treated with total laryngectomy for squamous cell carcinoma. Methods. This prospective study was conducted on a sample of patients enrolled from January 2019 to March 2022. All patients were subjected to a “protocol” of blood chemistry investigations, scheduled as follows: complete blood count with formula, ESR dosage, CPR, and PCT. PCT was also dosed by salivary sampling and a pharyngo-cutaneous swab in patients who presented with PCF. The dosage scheme was systematically repeated: the day before the intervention (t0); the 5th day postoperative (t1); the 20th day postoperative (t2); and at time X, the day of the eventual appearance of the pharyngocutaneous fistula. Results. A total of 36 patients met the inclusion criteria. The patients enrolled in the study were subsequently divided into two groups: 27 patients underwent total laryngectomy (TL) for laryngeal cancer without postoperative complications, and 9 patients were undergoing TL with postoperative PCF. Using the Cochran’s Q test, statistical significance was found for PCT among T0, T1, Tx, and T2 (p-value < 0.001) between the PCF and non-PCF groups. The Z test demonstrated that there is a difference in PCT levels at T1 and T2 and that this difference is statistically significant (p< 0.001). Conclusions. PCT could be considered an early marker of complications in open laryngeal surgery. According to our results, it could be useful in the precocious detection of pharyngocutaneous fistulas and in the management of antibiotic therapy.
目的。本前瞻性研究旨在探讨降钙素原作为早期诊断标志物，在因鳞状细胞癌接受全喉切除术的头颈部患者队列中，对咽皮瘘的诊断价值。方法。本研究为前瞻性研究，纳入2019年1月至2022年3月期间的患者样本。所有患者均按以下方案接受血液生化检测：全血细胞计数及分类、血沉、C反应蛋白和降钙素原。对于出现咽皮瘘的患者，还通过唾液采样和咽皮拭子检测降钙素原。检测方案系统性地重复进行：干预前一日（t0）、术后第5日（t1）、术后第20日（t2），以及在咽皮瘘最终出现的时间点X。结果。共36例患者符合纳入标准。研究患者随后分为两组：27例因喉癌接受全喉切除术且无术后并发症，9例接受全喉切除术后出现咽皮瘘。通过Cochran's Q检验发现，在咽皮瘘组与非咽皮瘘组之间，降钙素原在T0、T1、TX和T2时间点的差异具有统计学意义（p值<0.001）。Z检验表明，T1和T2时间点的降钙素原水平存在差异，且该差异具有统计学意义（p<0.001）。结论。降钙素原可被视为开放性喉部手术并发症的早期标志物。根据我们的研究结果，它可能有助于早期发现咽皮瘘并指导抗生素治疗管理。
肿瘤(癌症)患者之家