The Expression of CD64 and CD11b Neutrophils in Neonatal Necrotizing Enterocolitis

Abstract

Objectives: To investigate the expression of CD64 and CD11b neutrophils in neonates with necrotizing enterocolitis (NEC) and to evaluate the diagnostic value of CD64 and CD11b in identifying NEC in neonates. Methods: A total of 138 newborns, admitted to our neonatal intensive care unit from October 2018 to March 2020, were recruited in this study. The subjects were divided into the NEC and control groups, according to the method of case-control. The expression of CD64, CD11b, and C-reactive protein (CRP) was measured in the peripheral blood, the sensitivity and specificity of each index in diagnosing NEC were compared, and their diagnostic value was examined. Results: The corrected gestational age of the NEC and control groups was 32.29 ± 1.85 and 33.24 ± 1.98 weeks, respectively. The mean birth weight of the two groups was 1654 ± 373 and 1746 ± 400 g, respectively. Also, the mean age at sampling was 11.6 ± 3.11 and 11.7 ± 3.14 days in the NEC and control groups, respectively. Gender, corrected gestational age, mean birth weight, and sampling age were not significantly different between the groups (P > 0.05). The CD64 and CD11b expression levels were higher in the NEC group, compared to the control group (P < 0.01). Comparison of the NEC group by stage showed that the CD64 and CD11b indices were the highest in stage III, followed by stage II and stage I (P = 0.01). However, both indices showed a downward trend during the recovery period (P < 0.01). A CD64 level ≥ 0.71, a CD11b level of 1.94, and a CRP level ≥ 7.38 were considered as the best diagnostic criteria. The highest exponential sensitivity (82.7%) was attributed to the CD64 index, followed by CD11b (50.8%) and CRP (39.1%). The highest sensitivity (89%) was obtained by a combination of two indices (one positive index); also, when both indices were positive, the highest specificity (87%) was reported. The sensitivity of combined indices for NEC diagnosis in stage I, II and III were 84.4%, 95.7%, and 92.9%, respectively. Conclusions: The expression levels of CD64 and CD11b neutrophils in neonatal NEC increased and was associated with the severity of NEC. Monitoring of changes in the two indices had a clinical value in the diagnosis of NEC. In conclusion, the combined use of these two indices can be more valuable in the diagnosis of neonatal NEC.