Clinical Trials Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2022; 10(7): 2127-2137
Published online Mar 6, 2022. doi: 10.12998/wjcc.v10.i7.2127
Diagnostic performance of Neutrophil CD64 index, procalcitonin, and C-reactive protein for early sepsis in hematological patients
Yu-Xi Shang, Zhi Zheng, Min Wang, Hui-Xia Guo, Yi-Juan Chen, Yue Wu, Xing Li, Qian Li, Jian-Ying Cui, Xiao-Xiao Ren, Li-Ru Wang
Yu-Xi Shang, Min Wang, Hui-Xia Guo, Yi-Juan Chen, Yue Wu, Xing Li, Qian Li, Jian-Ying Cui, Xiao-Xiao Ren, Li-Ru Wang, Department of Hematology, Fuxing Hospital, Eighth Clinical Medical College, Capital Medical University, Beijing 100038, China
Zhi Zheng, Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Author contributions: Shang YX and Zheng Z contributed equally to this work, carried out the studies and participated in collecting the data; Shang YX and Zheng Z drafted the manuscript; Wang M, Guo HX, Wu Y, Li X and Chen YJ performed the statistical analysis and participated in its design; Li Q, Cui JY and Ren XX participated in acquisition, analysis, or interpretation of the data; Wang LR revised the manuscript; all authors read and approved the final manuscript.
Supported by Xicheng District Outstanding Talent Project (2018-2019, Shang YX), and Beijing Xicheng District Health Commission Young Science and Technology Talent (Science and Technology New Star) Training Project, No. xwkx2020-24.
Institutional review board statement: This study was approved by the Ethics Committee of Fuxing Hospital, Capital Medical University, No. 2014FXHEC-KY020.
Clinical trial registration statement: The trial was registered in March 2020 on the Chinese Clinical Trial Registry website (http://www.chictr.org.cn/index.aspx). The registration number is ChiCTR2100044348.
Informed consent statement: The Ethics Committee waived the need for informed consent due to the use of anonymized data for analysis.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Ru Wang, MD, PhD, Chief Doctor, Director, Doctor, Department of Hematology, Fuxing Hospital, Eighth Clinical Medical College, Capital Medical University, No. 20 Fuxing Street, Xicheng District, Beijing 100038, China. liruwang@ccmu.edu.cn
Received: July 20, 2021
Peer-review started: July 20, 2021
First decision: October 16, 2021
Revised: October 16, 2021
Accepted: January 19, 2022
Article in press: January 19, 2022
Published online: March 6, 2022
Processing time: 224 Days and 12.7 Hours
ARTICLE HIGHLIGHTS
Research background

This study confirmed that the neutrophil CD64 (nCD64) index can be used for early diagnosis of sepsis in hematological patients. The nCD64 index test may be an additional tool that could be routinely used for the identification of early sepsis in febrile hematological patients.

Research motivation

Our findings indicate that the nCD64 index is a valuable biomarker for early sepsis in hematological patients and is helpful in distinguishing sepsis from local infection, with the diagnostic efficacy of the nCD64 index being superior to that of high-sensitive C-reactive protein (hs-CRP) and procalcitonin (PCT).

Research objectives

The nCD64 index as a function of the infection status was as follows: Non-infected group, 0.74 ± 0.26; local infection group, 1.47 ± 1.10; and the sepsis group, 2.62 ± 1.60 (P < 0.001 between each group). The area under the diagnostic curve for the nCD64 index (difference between the sepsis and locally infected groups) was 0.777, which was higher than for the diagnostic curve using PCT (0.735) or hs-CRP (0.670). Overall, the positive and negative likelihood ratios were better for the nCD64 index than for PCT or hs-CRP.

Research methods

Patients with hematological disease treated at our hospital between March 2014 and December 2018 were analyzed. The nCD64 index was tested using flow cytometry and Leuko64 assay software. The factors which may affect the nCD64 index levels, as a function of infection status, were analyzed. The diagnostic efficacy of the nCD64 index, PCT, and hs-CRP for early sepsis in patients with hematological malignancies were compared.

Research results

In this study, we evaluated the diagnostic efficacy of the nCD64 index, PCT, and hs-CRP for early diagnosis of sepsis in patients with hematological diseases.

Research conclusions

Timely identification of early sepsis is very difficult in hematological patients due to the lack of specific clinical manifestations.

Research perspectives

Sepsis is a systemic, deleterious, host response to infection which can lead to severe sepsis and septic shock. Sepsis progresses rapidly and is associated with a high mortality rate, especially in hematological patients.