Expression of CD11b/CD18 adhesion molecules on circulating phagocytes-a novel aid to diagnose infection in patients with cancer.
OBJECTIVE
No blood marker available to date is useful for distinguishing infection-related from neoplasm-related fever. We evaluated the expression of the peripheral blood phagocyte CD11b/CD18 adhesion molecule complex for this purpose.


METHODS
Neutrophil and monocyte CD11b/CD18 expression was assessed in two cohorts of patients with advanced solid cancer (n = 120) and in healthy controls (n = 63). The cancer series included 89 patients with verified infection, 23 without infection, and eight with neoplastic fever. CD11b/CD18 expression was measured using flow cytometry, and serum C-reactive protein (CRP) concentration was determined with immunoturbidimetric assay.


RESULTS
Cancer patients with infection had higher blood neutrophil and monocyte CD11b/CD18 expression levels than patients with neoplastic fever, those with advanced cancer without infection, or healthy controls (p < 0.01 for all analyses). High CD11b/CD18 values were measured exclusively in individuals diagnosed with infection. Receiver-operating characteristic area under the curve (AUC) for neutrophil and monocyte CD11b/CD18 expression for the discrimination of infection from neoplastic fever was 0.80 (95% CI, 0.70 to 0.88), which was superior (p = 0.039 and p = 0.049, respectively) to serum CRP on admission (AUC 0.51, 0.40 to 0.62).


CONCLUSIONS
Peripheral blood phagocytic cell CD11b/CD18 expression is useful for making a differential diagnosis between infection and neoplasm-related fever in cancer patients.
Kallio
R
R
Department of Oncology and Radiotherapy, Oulu University Hospital, Box 22, 90029, Oulu, Finland. raija.kallio@oulu.fi
Aalto
H
H
Takala
A
A
Ohtonen
P
P
Collan
J
J
Siitonen
S
S
Joensuu
H
H
Syrjala
H
H
Repo
H
H
D000328:Adult; D000368:Aged; D039481:CD11b Antigen / Q000378:metabolism*; D018821:CD18 Antigens / Q000378:metabolism*; D016022:Case-Control Studies; D002448:Cell Adhesion; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007239:Infections / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism; D009369:Neoplasms / Q000150:complications*; D009504:Neutrophils / Q000378:metabolism; D011237:Predictive Value of Tests; D012372:ROC Curve; D015854:Up-Regulation
D039481:CD11b Antigen; D018821:CD18 Antigens; C509295:ITGAM protein, human