Faculty of Clinical Laboratory, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
Department of Central Clinical Laboratory, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan.
Int J Hematol. 2011 Aug;94(2):169-177. doi: 10.1007/s12185-011-0892-x. Epub 2011 Jul 6.
We evaluated the diagnostic utility of peripheral blood neutrophil distribution patterns obtained using the CELL-DYN SAPPHIRE hematology analyzer in patients with myelodysplastic syndrome (MDS). Peripheral blood was obtained from 467 individuals including 32 patients with MDS, and the respective neutrophil distribution patterns were observed using two light scatters [7-degree complexity (7D) and 90-degree lobularity (90D)]. These scattering intensities are shown as median (median neutrophil distribution: MND) and coefficient of variation (neutrophil distribution width: NDW). Generally, MDS patients showed lower 7D MND, higher 7D NDW, lower 90D MND and higher 90D NDW than other comparable groups. Whereas 90D parameters were more diagnostically efficient than 7D ones in patients with MDS. The sensitivity and specificity of 90D MND for MDS patients became 78.1 and 78.9%, respectively (cut-off value = 14,514). 90D NDW was most diagnostically effective with 87.5% sensitivity and 91.0% specificity (cut-off value = 21.2%). Both 90D parameters showed no evident correlation with the degree of either leukocytopenia or peripheral blood dysgranulopoiesis. In conclusion, neutrophil distribution parameters, especially 90D NDW, appear to provide convenient and objective markers for the screening of patients with MDS in routine laboratory hematology.
我们评估了使用 CELL-DYN SAPPHIRE 血液分析仪获得的骨髓增生异常综合征（MDS）患者外周血中性粒细胞分布模式的诊断效用。共采集了 467 名个体的外周血，包括 32 名 MDS 患者，并使用两个散射光（7 度复杂度（7D）和 90 度叶状（90D））观察各自的中性粒细胞分布模式。这些散射强度表示为中位数（中性粒细胞分布中位数：MND）和变异系数（中性粒细胞分布宽度：NDW）。通常，MDS 患者的 7D MND 较低，7D NDW 较高，90D MND 较低，90D NDW 较高。而 90D 参数在 MDS 患者中的诊断效率优于 7D 参数。90D MND 对 MDS 患者的敏感性和特异性分别为 78.1%和 78.9%（临界值=14,514）。90D NDW 的诊断效果最佳，敏感性为 87.5%，特异性为 91.0%（临界值=21.2%）。两种 90D 参数均与白细胞减少症或外周血粒系发育不良的程度均无明显相关性。总之，中性粒细胞分布参数，尤其是 90D NDW，似乎为常规实验室血液学 MDS 患者的筛查提供了便捷和客观的标志物。
