Clinical application of flow cytometric cytokine profiling in diagnosis of sepsis and assessment of mortality risk

Ma Jin; Yang Hao; Sun Changrui; Lei Yu; Wu Chunxiang

doi:10.13406/j.cnki.cyxb.003678

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Clinical application of flow cytometric cytokine profiling in diagnosis of sepsis and assessment of mortality risk

Clinical research | 更新时间：2025-10-23

- Clinical application of flow cytometric cytokine profiling in diagnosis of sepsis and assessment of mortality risk
- Journal of Chongqing Medical University Vol. 49, Issue 12, Pages: 1600-1607(2024)
- 作者机构：
  
  1.四川省医学科学院/四川省人民医院，临床医学检验中心
  2.医务部
  3.重症医学科，成都 610072
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003678
  CLC： R473.72
- Received：15 July 2024，
  
  Revised：2024-10-24，
  
  Accepted：26 October 2024，
  
  Published：28 December 2024
- 稿件说明：
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马晋,杨浩,孙昌瑞,等.流式细胞术细胞因子谱检测在脓毒症诊断及死亡风险评估中的临床应用[J].重庆医科大学学报,2024,49(12):1600-1607.

Ma Jin,Yang Hao,Sun Changrui,et al.Clinical application of flow cytometric cytokine profiling in diagnosis of sepsis and assessment of mortality risk[J].Journal of Chongqing Medical University,2024,49(12):1600-1607.
马晋,杨浩,孙昌瑞,等.流式细胞术细胞因子谱检测在脓毒症诊断及死亡风险评估中的临床应用[J].重庆医科大学学报,2024,49(12):1600-1607. DOI： 10.13406/j.cnki.cyxb.003678.

Ma Jin,Yang Hao,Sun Changrui,et al.Clinical application of flow cytometric cytokine profiling in diagnosis of sepsis and assessment of mortality risk[J].Journal of Chongqing Medical University,2024,49(12):1600-1607. DOI： 10.13406/j.cnki.cyxb.003678.

摘要

目的

研究流式细胞术细胞珠阵列（cytometric bead array，CBA）法检测脓毒症患者人细胞因子谱表达水平，探讨并比较各细胞因子在脓毒症患者早期诊断及预测死亡风险中的临床应用价值。

方法

纳入256例ICU脓毒症患者，99例健康体检者和99例ICU非脓毒症患者，流式细胞术CBA法检测入组人群入院当天血浆IL-2、IL-4、IL-6、IL-10、TNF-α和IFN-γ的水平。Spearman及R语言Mantel检验分别用于常规相关性分析和指标集合间的相关性分析，构建受试者工作特征曲线（receiver operating characteristic，ROC）曲线，评估并比较人细胞因子谱中各细胞因子对脓毒症患者早期诊断及预估死亡风险的应用价值。

结果

脓毒症患者血浆人细胞因子谱中IL-6、IL-10水平明显高于健康对照及ICU非脓毒症患者。IL-6的早期脓毒症诊断ROC曲线下面积（area under curve，AUC）为0.868（

0.000 1，95%CI=0.835~0.901），IL-10为0.831（

0.000 1，95%CI=0.793~0.869）。Mantel检验指标集合间的相关性分析显示：在脓毒症患者死亡组中，IL-6与CRP呈显著相关性（

=0.101，

=0.001），IL-10与NEUT呈显著相关性（

=0.132，

=0.001）。人细胞因子谱中的各细胞因子预测28 d死亡率的AUC均低于0.70。

结论

使用流式细胞术CBA法检测人细胞因子在脓毒症早期诊断中表现出不同的效力。IL-6和IL-10能为脓毒症的早期临床诊断提供证据，但在预估死亡风险方面与其他因子效力相当。

Abstract

Objective

To investigate the cytometric bead array（CBA） method in measuring the expression levels of human cytokine profiles in patients with sepsis，and to explore the clinical application value of different cytokines in the early diagnosis of sepsis and the prediction of mortality risk.

Methods

This study was conducted among 256 sepsis patients admitted to the intensive care unit （ICU），99 healthy individuals who underwent physical examination，and 99 non-sepsis patients admitted to the ICU，and the CBA method was used to measure the plasma levels of interleukin-2（IL-2），interleukin-4 （IL-4），interleukin-6（IL-6），interleukin-10 （IL-10），tumor necrosis factor-α（TNF-α），and interferon gamma（IFN-γ）. The Spearman and Mantel tests in R language were used for the routine correlation analysis and the correlation analysis between indicator sets，and the receiver operating characteristic（ROC） curve was plotted to assess the application value of each cytokine in the human cytokine profile in the early diagnosis of sepsis patients and the prediction of mortality risk.

Results

The sepsis patients had significantly higher plasma levels of IL-6 and IL-1

0 in the human cytokine profile than the healthy controls and the non-sepsis patients admitted to the ICU. IL-6 had an area under the ROC curve（AUC） of 0.868（95%CI=0.835-0.901，

0.000 1） in the early diagnosis of sepsis，while IL-10 had an AUC of 0.831（95%CI= 0.793-0.869，

0.000 1）. The correlation analysis of the indicator sets using the Mantel test showed a significant correlation between IL-6 and C-reactive protein in the sepsis mortality group（

=0.101，

=0.001），as well as a significant correlation between IL-10 and neutrophil count（

=0.132，

=0.001）. All cytokines in the human cytokine profile had an AUC of

0.70 in predicting 28-day mortality rate.

Conclusion

Human cytokines measured by the CBA method have varying degrees of efficacy in the early diagnosis of sepsis. While IL-6 and IL-10 can offer valuable evidence for the early clinical diagnosis of sepsis，they have comparable efficacy to other cytokines in predicting mortality risk

关键词

Keywords

references

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