Wenqian Qi,1 Junyan Han,2,3 Yu Cao,2,3 Hao Yu,2,3 Jingjing Hao,1 Ningning Yin,1 Xuefeng Zang,4 Lei Zhao,5 Wei Chen,4 Chen Chen,2,3 Hui Zeng,2,3 Jingyuan Liu,1 Ang Li1 

1Intensive Care Unit, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China; 2Biomedical Innovation Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People’s Republic of China; 3Beijing Key Laboratory for Therapeutic Cancer Vaccines, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People’s Republic of China; 4Department of Intensive Care Unit, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, 100038, People’s Republic of China; 5Department of Critical Care Medicine, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People’s Republic of China

Correspondence: Ang Li, Intensive Care Unit, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China, Email liang@ccmu.edu.cn

Background: Sepsis accounts for a significant proportion of global deaths and has limited treatment options. Cancer patients are at a higher risk of sepsis and experience worse outcomes, highlighting the complex interplay between sepsis and cancer on immune cell function and clinical prognosis.
Methods: Between July and December 2023, we prospectively enrolled 30 sepsis patients and 10 healthy controls, categorizing the patients into sepsis with non-cancer and sepsis with cancer based on established clinical diagnostics. Multi-color flow cytometry was used to monitor changes in the expression of surface molecules of monocyte and neutrophil subsets, phagocytic activity and cytokine-producing capacity.
Results: Compared with sepsis with non-cancer, the sepsis with cancer group demonstrated elevated 28-day mortality rates, increased CD177+ activated band neutrophil and HLA-DRlowCCR2low classical monocyte, and attenuated phagocytic activity of immature neutrophil and monocyte. Further, HLA-DRlowCCR2low classical monocytes and CD177+ myelocytes may serve as immunological predictors of adverse outcomes in sepsis. The HLA-DRlowCCR2low classical monocyte and CD177+ myelocytes exhibit significant correlations with internal environment and coagulation markers.
Conclusion: In septic patients, particularly those patients with cancer, attenuated phagocytic activity of immature neutrophil (myelocytes, metamyelocytes, band neutrophils) and monocyte, and HLA-DRlowCCR2low classical monocyte and CD177+ myelocytes may serve as immunological predictors of poor prognosis.

Keywords: sepsis, monocyte, neutrophil, cancer