title: Value of neutrophil CD16 expression for detection of left shift and acute-phase response.
abstract: Fc gamma RIII (CD16) expression of neutrophil granulocytes was measured in 156 patients by means of fluorescence-labeled antibodies with a flow cytometer. Results were compared with (1) 400-cell manual differential count; (2) left shift flagging on hematology analyzers; (3) absolute neutrophil count; and (4) acute-phase protein levels. Asynchrony was noted between neutrophil CD16 expression and microscopically defined neutrophil stage, particularly in heavily left-shifted samples, which made it impossible to reliably enumerate immature neutrophils on the basis of CD16 expression. According to receiver operating characteristics, the absolute count of CD16-negative neutrophils was highly discriminatory for detection of left shift, with an area under the curve (AUC) of 0.842 +/- 0.03 (SE) and maximum efficiency of 81% +/- 3%, but absolute neutrophil count was not significantly inferior (0.821 +/- 0.03 and 76% +/- 3%). STKS and SE9000 flagging demonstrated efficiency of 76% +/- 3% and 81% +/- 3%, respectively. For detection of acute-phase response, absolute neutrophil count (AUC, 0.836 +/- 0.04; maximum efficiency, 80% +/- 4%) outperformed both quantitative neutrophil CD16 expression (0.760 +/- 0.05; 75% +/- 4%) and absolute CD16-negative neutrophil count (0.757 +/- 0.05; 71% +/- 4%); absolute band count performed similarly (0.853 +/- 0.04; 79% +/- 4%) and showed high efficiency at high sensitivity and specificity. Efficiency of analyzer flagging for detection of acute-phase response was not superior to absolute neutrophil count (STKS, 77% +/- 4%; SE9000, 78% +/- 4%). In conclusion, the diagnostic value of measuring neutrophil CD16 expression was generally similar to that of less complicated analytes.
authors.affiliation: Central Laboratory, Wilhelminenspital, Vienna, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Hübl
authors.forename: S
authors.initials: S
authors.lastname: Andert
authors.forename: G
authors.initials: G
authors.lastname: Thum
authors.forename: S
authors.initials: S
authors.lastname: Ortner
authors.forename: P M
authors.initials: PM
authors.lastname: Bayer
mesh_terms: D000210:Acute-Phase Reaction / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D005434:Flow Cytometry / Q000379:methods*; D006801:Humans; D007958:Leukocyte Count / Q000379:methods*; D008875:Middle Aged; D009504:Neutrophils / Q000145:classification / Q000166:cytology* / Q000378:metabolism; D011237:Predictive Value of Tests; D012372:ROC Curve; D017452:Receptors, IgG / Q000096:biosynthesis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D017452:Receptors, IgG