Shao Min, Wu Ling, Huang Xiangping, Ouyang Qianhui, Peng Ya, Liu Sixiang, Xu Xu, Yi Qi, Liu Yi, Li Guoguang, Ning Ding, Wang Jia, Tan Chaochao, Huang Ying
Department of Clinical Laboratory, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China.
Gastroenterology department, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China.
Front Immunol. 2025 Apr 16;16:1526122. doi: 10.3389/fimmu.2025.1526122. eCollection 2025.
Effective early diagnosis and timely intervention in acute pancreatitis (AP) are essential for improving patient outcomes. This study aims to evaluate the clinical utility of the neutrophil CD64 index (nCD64) in stratifying patients with SAP and assessing mortality risk.
A total of 302 AP patients were enrolled and divided into a training cohort ( = 226) and a validation cohort ( = 76). Venous blood samples were collected within 24 hours of admission, and the nCD64 index was measured via flow cytometry. Other clinical parameters, including C-reactive protein (CRP) and procalcitonin (PCT), were also recorded. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic value of the nCD64 index and its capacity to predict mortality risk.
ROC curve analysis identified a cutoff value of 1.45 for the nCD64 index. Patients with nCD64 > 1.45 had significantly higher risks of complications, including systemic inflammatory response syndrome (SIRS), acute respiratory distress syndrome (ARDS), multiple organ failure (MOF), and death. Over 65% of patients with acute pancreatitis (AP) can be effectively risk-stratified at a low cost, and it has been demonstrated that AP patients with an nCD64 value ≤ 1.45 have an extremely low mortality rate (no mortality in present training and validation cohort). Kaplan-Meier survival analysis revealed a significant survival difference between high-risk (nCD64 > 1.45) and low-risk groups ( < 0.001).
The nCD64 index is an effective tool for early identification of SAP patients, allowing for the classification of over 65% of cases as low-risk for mortality.
急性胰腺炎（AP）的有效早期诊断和及时干预对于改善患者预后至关重要。本研究旨在评估中性粒细胞CD64指数（nCD64）在对重症急性胰腺炎（SAP）患者进行分层及评估死亡风险方面的临床应用价值。
共纳入302例AP患者，分为训练队列（n = 226）和验证队列（n = 76）。入院后24小时内采集静脉血样本，通过流式细胞术检测nCD64指数。还记录了其他临床参数，包括C反应蛋白（CRP）和降钙素原（PCT）。进行逻辑回归和受试者工作特征（ROC）曲线分析，以评估nCD64指数的诊断价值及其预测死亡风险的能力。
ROC曲线分析确定nCD64指数的临界值为1.45。nCD64>1.45的患者发生并发症的风险显著更高，包括全身炎症反应综合征（SIRS）、急性呼吸窘迫综合征（ARDS）、多器官功能衰竭（MOF）和死亡。超过65%的急性胰腺炎（AP）患者可以以低成本进行有效的风险分层，并且已证明nCD64值≤1.45的AP患者死亡率极低（在目前的训练和验证队列中无死亡病例）。Kaplan-Meier生存分析显示高风险组（nCD64>1.45）和低风险组之间存在显著生存差异（P<0.001）。
nCD64指数是早期识别SAP患者的有效工具，可将超过65%的病例分类为低死亡风险。
