Clinical Laboratory, Tokai University Hospital, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Department of Laboratory Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan; Division of Pathology and Clinical Laboratories, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Clin Chim Acta. 2019 Feb;489:249-253. doi: 10.1016/j.cca.2018.08.038. Epub 2018 Aug 27.
This study aimed to develop a simple and inexpensive method using the complete blood count (CBC) and differentials to screen for chronic myeloid leukemia (CML).
The receiver operating characteristic (ROC) curves of each CBC parameter, differential and the neutrophil alkaline phosphatase (NAP) score using CML and non-CML cases were generated to determine effective cut-off values. They were applied to the review of randomly-selected 45,608 samples for validation.
The leukocyte count showed the highest area under the ROC curve (AUC) value (0.909) among the CBC parameters. In the absolute counts of differentials, the AUC was the highest in basophils (0.982), followed by immature granulocytes (IGs) (0.975), which had cut-off values of 0.43 × 10/L and 0.46 × 10/L, respectively. The AUC of the NAP score was 0.963 at a cut-off value 122. In the validation, the absolute basophil counts were elevated in 280 samples from 96 cases, including 22 CML cases. In contrast, the absolute IG counts were elevated in 1310 samples from 516 cases, including only 17 CML cases. Three newly-diagnosed CML cases whose data were analyzed sequentially at the CML onset consistently met the basophil criteria before the IG criteria.
The absolute basophil count is effective for screening for CML.
本研究旨在开发一种使用全血细胞计数（CBC）和分类计数来筛查慢性髓系白血病（CML）的简单且廉价的方法。
生成了每个 CBC 参数、分类计数和中性粒细胞碱性磷酸酶（NAP）评分的受试者工作特征（ROC）曲线，以确定有效的临界值。将它们应用于随机选择的 45608 个样本进行验证。
白细胞计数在 CBC 参数中显示出最高的 ROC 曲线下面积（AUC）值（0.909）。在分类计数的绝对值中，嗜碱性粒细胞的 AUC 最高（0.982），其次是未成熟粒细胞（IG）（0.975），其临界值分别为 0.43×10/L 和 0.46×10/L。NAP 评分的 AUC 值为 122 时为 0.963。在验证中，96 例中有 280 例（280 例）样本的绝对嗜碱性粒细胞计数升高，其中包括 22 例 CML 病例。相比之下，516 例中有 1310 例（1310 例）样本的绝对 IG 计数升高，其中仅 17 例 CML 病例。对 CML 发病时依次进行数据分析的 3 例新诊断 CML 病例，在 IG 标准之前均符合嗜碱性粒细胞标准。
绝对嗜碱性粒细胞计数对筛查 CML 有效。
