Correlation analysis of serum CD354 and ANGPT2 levels with the prognosis of sepsis
Serum CD354 and ANGPT2 levels in the prognosis of sepsis
Abstract
[Objective] To explore the changes of procalcitonin (PCT), Angiopoietin-2 (ANGPT2), and serum Cluster of Differentiation 354 (CD354) concentrations in pediatric sepsis patients.
[Methods] 190 children with sepsis who were hospitalized to our hospital between January 2024 and June 2025 had their clinical data analyzed retrospectively. Based on the severity of their conditions, the patients were divided into a severe group (n = 84) and a nonsevere group (n = 106). A survival group (n = 134) and a death group (n = 56) were created based on the prognosis of the two groups of children within 28 days after admission. Serum levels of CD354, ANGPT2, and PCT in the severe and nonsevere groups were compared, and the predictive efficacy of these indicators alone or in combination for assessing the severity of sepsis in children was determined using receiver operating characteristic (ROC) curves. The differences in serum CD354, ANGPT2 and PCT levels between the survival group and the death group were compared, and the predictive efficacy of these indicators alone or in combination for evaluating the prognosis of sepsis in children was determined using receiver operating characteristic (ROC) curves.
[Results] The serum CD354, ANGPT2 and PCT levels were higher in the severe group than in the nonsevere group (P < 0.05). The sensitivity and specificity of serum CD354 for evaluating the severity of sepsis in children were 92.48% and 66.60%, respectively. The sensitivity and specificity of serum ANGPT2 for evaluating the severity of sepsis in children were 94.37% and 88.13%, respectively. The sensitivity and specificity of serum PCT for evaluating the severity of sepsis in children were 94.37% and 66.60%, respectively. The sensitivity and specificity of serum ANGPT2 for evaluating the severity of sepsis in children were 94.37% and 88.13%, respectively. The sensitivity and specificity of serum PCT for evaluating the prognosis of sepsis in children were 64.22% and 100.00%, respectively. Children who died had greater levels of serum CD354, ANGPT2, and PCT than children who survived (P < 0.05). For assessing the prognosis of sepsis in children, serum CD354 has sensitivity of 53.50% and specificity of 83.51%. Serum ANGPT2 has sensitivity and specificity of 82.17% and 98.54%, respectively, for assessing the prognosis of sepsis in children. The sensitivity and specificity of serum PCT for evaluating the prognosis of sepsis in children were 64.22% and 100.00%, respectively.
[Conclusion] Serum CD354, ANGPT2 and PCT levels significantly guide the assessment of the severity of the condition in children with sepsis and provide important reference values for prognosis.
References
2.Lane RD, Richardson T, Scott HF, Paul RM, Balamuth F, Eisenberg MA, Riggs R, Huskins WC, Horvat CM, Keeney GE, Hueschen LA, Lockwood JM, Gunnala V, McKee BP, Patankar N, Pinto VL, Sebring AM, Sharron MP, Treseler J, Wilkes JJ, Workman JK. Delays to Antibiotics in the Emergency Department and Risk of Mortality in Children With Sepsis. JAMA Netw Open. 2024 Jun 3;7(6):e2413955. doi: 10.1001/jamanetworkopen.2024.13955. Erratum in: JAMA Netw Open. 2024 Dec 2;7(12):e2455269. doi: 10.1001/jamanetworkopen.2024.55269. PMID: 38837160; PMCID: PMC11154154.
3.Peters E, Rhodes A, Measey MA, Babl FE, Long E. Sepsis awareness and understanding in Australian parents: A National Child Health Poll survey. J Paediatr Child Health. 2023 Sep;59(9):1047-1052. doi: 10.1111/jpc.16453. Epub 2023 Jun 16. PMID: 37326211.
4.Georgette N, Michelson K, Monuteaux M, Eisenberg MA. Comparing Screening Tools for Predicting Phoenix Criteria Sepsis and Septic Shock Among Children. Pediatrics. 2025 May 1;155(5):e2025071155. doi: 10.1542/peds.2025-071155. PMID: 40287144.
5.Stanski NL, Gist KM, Hasson D, Stenson EK, Seo J, Ollberding NJ, Muff-Luett M, Cortina G, Alobaidi R, See E, Kaddourah A, Fuhrman DY; Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) Investigators. Characteristics and Outcomes of Children and Young Adults With Sepsis Requiring Continuous Renal Replacement Therapy: A Comparative Analysis From the Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK). Crit Care Med. 2024 Nov 1;52(11):1686-1699. doi: 10.1097/CCM.0000000000006405. Epub 2024 Sep 11. PMID: 39258974; PMCID: PMC11881206.
6.Rutman L, Richardson T, Auletta J, Balamuth F, Chambers A, Fitzgerald J, Gelvez J, Genzel KA, Grant A, Gunnala V, Hakim H, Hueschen L, Kandil S, Larsen G, Lockwood J, Lucey K, Mack E, Madden K, Niedner M, Paul R, Reddy A, Riggs R, Rosen J, Schafer M, Scott H, Wilkes J, Eisenberg MA; Improving Pediatric Sepsis Outcomes Collaborative Investigators. Association between Child Opportunity Index and pediatric sepsis recognition and treatment in a large quality improvement collaborative: a retrospective cohort study. BMJ Qual Saf. 2026 Jan 19;35(2):106-117. doi: 10.1136/bmjqs-2024-017844. PMID: 40345682.
7.Castagno E, Aguzzi S, Rossi L, Gallo R, Carpino A, Ricceri F, Urbino AF, Bondone C. Clinical Predictors and Biomarkers in Children With Sepsis and Bacterial Meningitis. Pediatr Emerg Care. 2023 May 1;39(5):311-317. doi: 10.1097/PEC.0000000000002865. Epub 2023 Jan 30. PMID: 36715265.
8.Xu L, Li J, Hu Z. Giardiasis Combined with Sepsis and DIC in a Chinese Child from Ganzi Tibetan Autonomous Prefecture. Clin Lab. 2024 Jan 1;70(1). doi: 10.7754/Clin.Lab.2023.230658. PMID: 38213213.
9.Kim ME, Goldstein SL, Chlebowski MM. Recombinant angiotensin II therapy in a child with cardiac dysfunction and Pandoraea and Candida sepsis. Cardiol Young. 2023 Nov;33(11):2393-2394. doi: 10.1017/S1047951123001221. Epub 2023 May 22. PMID: 37212085.
10.Sankar J, Thakral V, Bharadwaj K, Agarwal S, Kabra SK, Lodha R, Rathore S. The Microbiome and Metabolome of the Gut of Children with Sepsis and Septic Shock. J Intensive Care Med. 2024 Jun;39(6):514-524. doi: 10.1177/08850666231216361. Epub 2023 Dec 10. PMID: 38073164.
11.Sanchez-Pinto LN, Daniels LA, Atreya M, Faustino EVS, Farris RWD, Geva A, Khemani RG, Rogerson C, Shah SS, Weiss SL, Bennett TD. Phoenix Sepsis Criteria in Critically Ill Children: Retrospective Validation Using a United States Nine-Center Dataset, 2012-2018. Pediatr Crit Care Med. 2025 Feb 1;26(2):e155-e165. doi: 10.1097/PCC.0000000000003675. Epub 2025 Feb 6. PMID: 39982153; PMCID: PMC11792981.
12.Stephen RJ, Lucey K, Carroll MS, Hoge J, Maciorowski K, Jones RC, O'Connell M, Schwab C, Rojas J, Sanchez Pinto LN. Sepsis Prediction in Hospitalized Children: Clinical Decision Support Design and Deployment. Hosp Pediatr. 2023 Sep 1;13(9):751-759. doi: 10.1542/hpeds.2023-007218. PMID: 37599646.
13.Beltrán Hernandez B, Fernández-Sarmiento J, Mulett H, Niño Ariza MC, Aguirre Gutierrez V, Cárdenas C, Cardona MP, Bernal Sierra T, Cabezas Rosas M, Garzón Angel L, Sarta M, Fernández-Sarta JP, La Rotta I, Buelvas-Pérez J, Rodriguez LS, Barrera Suárez MJ, Kissoon N; Microcirculation-Colombia (MICRO-COL) Research Group. Hyperprocalcitonemia and Endothelial and Microcirculatory Dysfunction in Children With Sepsis and Septic Shock: Single-Center Observational Cohort Study in Colombia, 2021-2024. Pediatr Crit Care Med. 2025 Aug 1;26(8):e1024-e1033. doi: 10.1097/PCC.0000000000003782. Epub 2025 Jun 25. PMID: 40558606.
14.Stephen RJ, Carroll MS, Hoge J, Maciorowski K, Jones RC, Lucey K, O'Connell M, Schwab C, Rojas J, Sanchez-Pinto LN. Sepsis Prediction in Hospitalized Children: Model Development and Validation. Hosp Pediatr. 2023 Sep 1;13(9):760-767. doi: 10.1542/hpeds.2022-006964. PMID: 37599645.
15.Morgan RW, Reeder RW, Carcillo JA, Carpenter TC, Fitzgerald JC, Graham K, Kilbaugh TJ, Meert KL, Nadkarni VM, Palmer CA, Sharron MP, Weiss SL, Wolfe HA, Ahmed T, Bell MJ, Bishop R, Burns C, Diddle JW, Fink EL, Franzon D, Frazier AH, Friess SH, Hehir DA, Horvat CM, Huard LL, Maa T, McQuillen PS, Mourani PM, Naim MY, Pollack MM, Sapru A, Srivastava N, Yates AR, Berg RA, Sutton RM; for the ICU-Resuscitation Project (ICU-RESUS) Investigators and the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network Investigators. Outcomes, Characteristics, and Physiology of In-Hospital Cardiac Arrest in Children With Sepsis. Crit Care Med. 2025 Aug 1;53(8):e1529-e1541. doi: 10.1097/CCM.0000000000006739. Epub 2025 Jun 25. PMID: 40558671; PMCID: PMC12286578.
16.Fernández-Sarmiento J, Hernández-Sarmiento R, Salazar MP, Barrera S, Castilla V, Duque C. The association between hypoalbuminemia and microcirculation, endothelium, and glycocalyx disorders in children with sepsis. Microcirculation. 2023 Nov;30(8):e12829. doi: 10.1111/micc.12829. Epub 2023 Aug 28. PMID: 37639384.
17.Capossela L, Margiotta G, Ferretti S, Curatola A, Bertolaso C, Pansini V, Di Sarno L, Gatto A. Presepsin as a diagnostic marker of sepsis in children and adolescents: a short critical update. Acta Biomed. 2023 Jun 14;94(3):e2023062. doi: 10.23750/abm.v94i3.13358. PMID: 37326282; PMCID: PMC10308464.
18.Casini F, Valentino MS, Lorenzo MG, Caiazzo R, Coppola C, David D, Di Tonno R, Giacomet V. Use of transcriptomics for diagnosis of infections and sepsis in children: A narrative review. Acta Paediatr. 2024 Apr;113(4):670-676. doi: 10.1111/apa.17119. Epub 2024 Jan 19. PMID: 38243675.
19.Formeck CL, Feldman R, Althouse AD, Kellum JA. Risk and Timing of De Novo Sepsis in Critically Ill Children after Acute Kidney Injury. Kidney360. 2023 Mar 1;4(3):308-315. doi: 10.34067/KID.0005082022. PMID: 36996298; PMCID: PMC10103342.
20.Schlapbach LJ, Ganesamoorthy D, Wilson C, Raman S, George S, Snelling PJ, Phillips N, Irwin A, Sharp N, Le Marsney R, Chavan A, Hempenstall A, Bialasiewicz S, MacDonald AD, Grimwood K, Kling JC, McPherson SJ, Blumenthal A, Kaforou M, Levin M, Herberg JA, Gibbons KS, Coin LJM; EUCLIDS consortium; RAPIDS Study Group. Host gene expression signatures to identify infection type and organ dysfunction in children evaluated for sepsis: a multicenter cohort study. Lancet Child Adolesc Health. 2024 May;8(5):325-338. doi: 10.1016/S2352-4642(24)00017-8. Epub 2024 Mar 19. PMID: 38513681.
21.McDonald G, Hayman R, Hii J. Burden and distribution of mortality due to sepsis and severe infection in children and adolescents in Aotearoa/New Zealand. J Paediatr Child Health. 2024 Apr-May;60(4-5):113-117. doi: 10.1111/jpc.16538. Epub 2024 Apr 6. PMID: 38581283.
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