Park S H, Park C-J, Lee B-R, Nam K-S, Kim M-J, Han M-Y, Kim Y J, Cho Y-U, Jang S
Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Int J Lab Hematol. 2015 Apr;37(2):190-8. doi: 10.1111/ijlh.12261. Epub 2014 May 28.
The Sysmex XN-2000 analyzer can assess 36 routine and 57 cell population data (CPD) items. In this study, we evaluated these items as sepsis biomarkers.
We enrolled 280 normal control (NC) and 130 sepsis patients. The sepsis patients were classified as uncomplicated or complicated sepsis. Routine and CPD items were determined, and the results were compared at between the NC and sepsis groups, uncomplicated and complicated sepsis groups, and survivors and nonsurvivors.
For the detection of sepsis, CPD items NE-SFL [defined as the fluorescent light intensity of the neutrophil area on the WDF (white blood cell differential) scattergram] and NE-WY (defined as the fluorescent light distribution width of the neutrophil area on the WDF scattergram) showed comparative or higher AUC of 0.909 and 0.905, respectively, when compared with routine items such as hematocrit, hemoglobin, RBC, RDW, immature granulocytes count, lymphocytes count, and neutrophils count. For the discrimination of sepsis severity, only platelet-related items showed higher AUC (0.723 - 0.748) than lactic acid (0.695). For the prediction of 28-day mortality, only CV and SD of RDW showed higher AUC (0.766 and 0.732 each) than lactic acid (0.712).
Sepsis patients demonstrated significant changes in routine and CPD items related to RBC, neutrophils, lymphocytes, and platelets when compared to NCs. Increase in CPD items NE-SFL and NE-WY, which may indicate neutrophil immaturity or activation, could be useful for the detection of sepsis patients, in conjunction with currently used surrogate sepsis biomarkers. However, these items did not efficiently contribute to the discrimination of sepsis severity or predict mortality.
Sysmex XN - 2000分析仪可评估36项常规指标和57项细胞群体数据（CPD）项目。在本研究中，我们将这些项目评估为脓毒症生物标志物。
我们纳入了280名正常对照（NC）和130名脓毒症患者。脓毒症患者被分为非复杂性或复杂性脓毒症。测定常规指标和CPD项目，并比较NC组与脓毒症组、非复杂性与复杂性脓毒症组以及存活者与非存活者之间的结果。
对于脓毒症的检测，与诸如血细胞比容、血红蛋白、红细胞计数、红细胞分布宽度、未成熟粒细胞计数、淋巴细胞计数和中性粒细胞计数等常规指标相比，CPD项目NE - SFL（定义为白细胞分类（WDF）散点图上中性粒细胞区域的荧光强度）和NE - WY（定义为WDF散点图上中性粒细胞区域的荧光分布宽度）分别显示出相对较高或更高的曲线下面积（AUC），分别为0.909和0.905。对于脓毒症严重程度的鉴别，只有血小板相关指标显示出比乳酸（0.695）更高的AUC（0.723 - 0.748）。对于28天死亡率的预测，只有红细胞分布宽度的变异系数（CV）和标准差（SD）显示出比乳酸（0.712）更高的AUC（分别为0.766和0.732）。
与NC组相比，脓毒症患者在与红细胞、中性粒细胞、淋巴细胞和血小板相关的常规指标和CPD项目中表现出显著变化。CPD项目NE - SFL和NE - WY的增加可能表明中性粒细胞不成熟或激活，与目前使用的替代脓毒症生物标志物一起，可能有助于检测脓毒症患者。然而，这些项目对脓毒症严重程度的鉴别或死亡率的预测没有有效作用。
