A retrospetive study was conducted. A total of 176
systemic inflammatory response syndrome (SIRS) patients in Department of
Critical Care Medicine of Xinxiang Medical College First Affiliated Hospital from March to November in 2014 were enrolled. The patients were divided into no
sepsis group (n=66), pulmonary originated
sepsis group (n=65), and non-pulmonary originated
sepsis group (n=45). Plasma
IL-27 and
procalcitonin (PCT) were determined with
enzyme linked
immunosorbent assay (ELISA). Receiver operating characteristic curve (ROC) and classification and regression tree methodology was used to evaluate diagnostic
biomarker performance.
RESULTS: The proportion of patients in pulmonary original
sepsis group whose body temperature in line with SIRS criteria was significantly higher than no
sepsis group (66.2% vs. 44.5%, P<0.05), and they were easy to suffer from
tumor (44.6% vs. 22.7%, P<0.05). The proportion of patients in non-pulmonary originated
sepsis group whose white blood cell count in line with SIRS criteria was significantly higher than no
sepsis group (68.9% vs. 42.7%, P<0.05). It indicated that patients in pulmonary originated
sepsis group and non-pulmonary originated
sepsis group were more in line with SIRS criteria compared with no
sepsis group. It was shown by ROC curve that
IL-27 and PCT was not effective in discriminating
sepsis among unselected patients showing symptoms and signs of SIRS. The area under the curve (AUC) was 0.59 [95% confidence interval (95%CI)=0.49-0.65] and 0.61 (95%CI=0.55-0.71). According to the further analysis from different
infection sources, the highest AUC was 0.71 (95%CI=0.59-0.79) for
IL-27 in patients with a non-pulmonary originated
sepsis. A decision tree incorporating
IL-27, PCT, and age had an AUC of 0.78 (95%CI=0.71-0.87) in patients with a non-pulmonary originated
sepsis, which was higher than
IL-27 [0.71(95%CI=0.59-0.79)] or PCT [0.65 (95%CI=0.57-0.78)]. Compared to that of pediatric cohort with
sepsis, lower expression of
IL-27 was found in adult patients.
CONCLUSIONS:
IL-27 performed overall poorly as a
sepsis diagnostic
biomarker in adults.
IL-27 may be a more reliable diagnostic
biomarker for
sepsis in children than in adults. The combination of
IL-27 and PCT can reasonably estimate the risk of
sepsis in subjects with a non-pulmonary originated
sepsis.