Kanungo Rahul, Hippargi Surekha B
Pathology, Shri B.M. Patil Medical College, Hospital and Research Centre, Bijapur Lingayat District Educational Association (BLDE) (Deemed to be University), Vijayapura, IND.
Cureus. 2024 Oct 20;16(10):e71912. doi: 10.7759/cureus.71912. eCollection 2024 Oct.
Introduction Neutrophils that are at rest exhibit very low expression of CD64, the high-affinity immunoglobulin fragment crystallizable γ receptor I, which is also found in monocytes. Neutrophils that have been exposed to endotoxins or are infected express more CD64. Objectives The aim of this study was to assess the CD64 biomarker expression on neutrophils using the flow cytometry method and its comparison with total leukocyte count, C-reactive protein (CRP) level, and blood culture sensitivity test in the diagnosis of sepsis in adults. Materials and methods Using the quick Sequential Organ Failure Assessment (qSOFA) scoring criteria, 94 blood samples from individuals with clinical indications of sepsis were included in this investigation. Samples were collected in K2 EDTA (ethylenediaminetetraacetic acid) vacutainers and analyzed for neutrophil CD64 (nCD64) levels using BD FACSLyric flow cytometer (BD, Franklin Lakes, NJ) within 24 hours of collection. Total leukocyte count, CRP levels, and blood culture sensitivity tests were also assessed simultaneously. Results Majority of the patients, i.e., 29 (30.9%), belonged to the age group of 19 to 35 years, with a female preponderance. The mean total leukocyte count was 19.49 ± 8.12 x 10/µL, mean CRP level was 81.19 ± 56.33 mg/dL, and the mean nCD64 expression - median fluorescence intensity was 197.26 ± 79.56. A positive blood culture was found in 59 (62.8%) cases. Neutrophils showed bright expression of nCD64 in 39 (41.5%) patients, dim expression in 35 (37.2%) patients, and moderate expression in 20 (21.3%) patients in the present study. The correlation between nCD64 expression with CRP, total leukocyte count, and blood culture sensitivity test was statistically significant (p=0.001). nCD64 expression showed a sensitivity of 93.2% and specificity of 91.4% for diagnosing sepsis, with an area under the curve (AUC) of 0.973. This proves nCD64 to be a highly effective biomarker compared to conventional methods. Conclusion nCD64 has a higher sensitivity and specificity as compared to total leukocyte count, CRP levels, and blood culture sensitivity test in the diagnosis of sepsis. It is an effective and rapid test that can enhance sepsis diagnostic accuracy, when combined with other biomarkers. Multicentric research needs to be conducted to validate these findings.
静息状态下的中性粒细胞对CD64（高亲和力免疫球蛋白可结晶片段γ受体I）的表达非常低，单核细胞中也存在该受体。接触过内毒素或受到感染的中性粒细胞会表达更多的CD64。
本研究旨在使用流式细胞术评估中性粒细胞上CD64生物标志物的表达，并将其与全白细胞计数、C反应蛋白（CRP）水平以及血培养敏感性试验在成人脓毒症诊断中的结果进行比较。
采用快速序贯器官衰竭评估（qSOFA）评分标准，本研究纳入了94例有脓毒症临床指征患者的血样。样本采集于含K2乙二胺四乙酸（EDTA）的真空采血管中，并在采集后24小时内使用BD FACSLyric流式细胞仪（BD公司，新泽西州富兰克林湖）分析中性粒细胞CD64（nCD64）水平。同时还评估了全白细胞计数、CRP水平和血培养敏感性试验。
大多数患者（即29例，占30.9%）年龄在19至35岁之间，女性居多。全白细胞计数平均值为19.49±8.12×10⁹/µL，CRP水平平均值为81.19±56.33mg/dL，nCD64表达的平均中位荧光强度为197.26±79.56。59例（62.8%）血培养呈阳性。在本研究中，39例（41.5%）患者的中性粒细胞nCD64表达明亮，35例（37.2%）患者表达暗淡，20例（21.3%）患者表达中等。nCD64表达与CRP、全白细胞计数和血培养敏感性试验之间的相关性具有统计学意义（p = 0.001）。nCD64表达对脓毒症诊断的敏感性为93.2%，特异性为91.4%，曲线下面积（AUC）为0.973。这证明与传统方法相比，nCD64是一种高效的生物标志物。
在脓毒症诊断中，与全白细胞计数、CRP水平和血培养敏感性试验相比，nCD64具有更高的敏感性和特异性。它是一种有效且快速的检测方法，与其他生物标志物联合使用时可提高脓毒症诊断的准确性。需要进行多中心研究来验证这些发现。
