title: Delta mean neutrophil volume (ΔMNV) is comparable to procalcitonin for predicting postsurgical bacterial infection.
abstract: BACKGROUND
  The Coulter LH750 (Beckman Coulter, Brea, CA) analyzer can determine intrinsic biophysical properties of white blood cell (WBC), known as cell population data. Previous studies have shown that mean neutrophil volume (MNV) was significantly increased in postsurgical patients with bacterial infection. To further validate its potential clinical usefulness, we investigate the changes in MNV before and after surgery, called ΔMNV. We also compare the ΔMNV with procalcitonin (PCT) and C-reactive protein (CRP) in terms of diagnostic sensitivity and specificity for postsurgical bacterial infection.
  
  
  METHODS
  Blood samples from 300 healthy controls, 219 cardiac surgical patients without postsurgical infection, and 31 cardiac surgical patients complicated with postsurgical bacterial infection were studied.
  
  
  RESULTS
  There are no statistically significant differences for WBC count and neutrophil percentage prior to or after surgery between postsurgical noninfected and infected patients. However, the ΔMNV is significantly increased in postsurgical infected patients when compared with noninfected patients (P < 0.05). The receiver-operating characteristics analysis reveals the ΔMNV and PCT have largest areas under curves (0.92, 0.93 on the second day and 0.94, 0.99 on the third day postsurgery, respectively) compared to other parameters.
  
  
  CONCLUSIONS
  ΔMNV shows comparable sensitivity and specificity to PCT and superior sensitivity and specificity to WBC or CRP for predicting postsurgical bacterial infection. The potential clinical application of this parameter merits further exploration in a larger prospective study.
authors.affiliation: Center of Clinical Laboratory Medicine, The Second Affiliated Hospital of Nantong University, Nantong, China.
authors.forename: Yihua
authors.initials: Y
authors.lastname: Zhu
authors.forename: Xingjian
authors.initials: X
authors.lastname: Cao
authors.forename: Kexia
authors.initials: K
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Xie
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Xu
authors.forename: Chongjun
authors.initials: C
authors.lastname: Zhong
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000175:diagnosis*; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000378:metabolism*; D015740:Calcitonin Gene-Related Peptide; D048429:Cell Size; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology*; D011498:Protein Precursors / Q000378:metabolism*; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide
keywords: delta mean neutrophil volume; neutrophil cell population data; postsurgical infection; procalcitonin