ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Infectious Diseases
Volume 13 - 2025 | doi: 10.3389/fped.2025.1599694
The clinical value of immune cell composition in the diagnosis of pediatric sepsis
Provisionally accepted
- Suqian First People's Hospital, Suqian, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background The objective of this study was to evaluate the diagnostic significance of various immune cell ratios in children with sepsis via the analysis of clinical data. Methods This retrospective study analyzed clinical data admitted to the pediatric intensive care unit (PICU) of Jiangsu Province (Suqian) Hospital between January 2023 and December 2024. Receiver operating characteristic (ROC) curve analysis evaluated the diagnostic performance of peripheral blood laboratory assessments and Immune cell ratios (platelet count divided by lymphocyte count (PLR), monocyte count divided by lymphocyte count (MLR), neutrophil count divided by lymphocyte count (NLR), the ratio of neutrophils to (white blood cells - neutrophils) (dNLR), and neutrophil count multiplied by 100 divided by (lymphocyte count multiplied by platelet count) (NLPR)). Using Statistical Package for the Social Sciences (SPSS) 26.0 performed by Mann-Whitney U and Chi-square tests, with significance defined as P < 0.05. Result We analyzed the clinical data from 321 pediatric patients (201 sepsis (SP) and 120 healthy controls (HC)). Compared to HC, the SP group exhibited elevated white blood cell (WBC), neutrophils, procalcitonin (PCT), platelets (PLT), and erythrocyte sedimentation rate (ESR) but reduced lymphocytes, monocytes, and hemoglobin; C-reactive protein (CRP) was significantly increased in the SP group (P < 0.001). ROC analysis identified NLR (The area under the ROC curve (AUC)=0.932), PLR (AUC=0.907), and NLPR (AUC=0.848) as effective immune ratio biomarkers, while MLR (AUC=0.784) showed limited utility. Among laboratory tests, WBC (AUC=0.902), neutrophils (AUC=0.919), CRP (AUC=0.923), PLT (AUC=0.879), and ESR (AUC=0.875) demonstrated strong diagnostic accuracy, whereas lymphocyte, monocyte, and hemoglobin levels were less discriminative. Conclusion Our study reveals that combining immune cell ratios and CRP significantly enhances early detection of pediatric sepsis, improving clinical outcomes.
Keywords: Sepsis, immune cells, Infection, NLR, ROC
Received: 25 Mar 2025; Accepted: 08 Jul 2025.
Copyright: © 2025 Shen, Zhong, Su, Shen, Li, Sun, Zhang and Qi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jijin Qi, Suqian First People's Hospital, Suqian, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.