Procalcitonin as an excellent differential marker between uncomplicated and complicated acute appendicitis in adult patients

  • Yanxiu Li
  • Zhongwen Zhang
  • Iokfai Cheang
  • Xinli LiEmail author
Original Article



The aim of this study was to assay the variation of procalcitonin (PCT) in adult patients with uncomplicated and complicated acute appendicitis.


In total, 336 patients who underwent appendectomy from January 2016 to December 2017 were enrolled. Levels of inflammatory markers, the highest body temperature within the first 24 h of admission (BTm) and the duration of operation were recorded. All appendectomy specimens were sent for histopathological examination. According to the histopathological results, 336 patients who underwent appendectomy were divided into uncomplicated acute appendicitis (UAA) group (246 cases) and complicated acute appendicitis (CAA) group (90 cases) for further analysis. The relationships of procalcitonin (PCT) and related indicators with UAA and CAA were evaluated by receiver operating characteristic (ROC) and binary logistic regression analysis.


Age, the levels of PCT, and CRP were significantly higher in CAA group (P < 0.05). Spearman correlation analysis showed that PCT was positively correlated with age (r = 0.452, P < 0.01) and CRP (r = 0.715, P < 0.01). The area under the curve (AUC) of PCT, CRP and age were 0.987, 0.902, and 0.748, respectively. ROC analysis showed when PCT > 0.42 ng/ml, it maximized the sensitivity and specificity. Logistic regression analysis indicated that PCT remained an independent risk factor for diagnosing CAA after adjusting with age and CRP (P < 0.05).


Serum PCT levels increased significantly in patients with CAA. PCT could provide convenient evaluation method for the optimal treatment of acute appendicitis.


Procalcitonin (PCT) Complicated acute appendicitis (CAA) Treatment Appendectomy ROC curve 


Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest and have no relationships relevant to the contents of this paper to disclose.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Yanxiu Li
    • 1
    • 2
  • Zhongwen Zhang
    • 3
  • Iokfai Cheang
    • 1
  • Xinli Li
    • 1
    Email author
  1. 1.Department of CardiologyFirst Affiliated Hospital with Nanjing Medical UniversityNanjingChina
  2. 2.ICUFirst Affiliated Hospital with Nanjing Medical UniversityNanjingChina
  3. 3.Department of General SurgeryThe Affiliated Jiangning Hospital of Nanjing Medical UniversityNanjingChina

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