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在护理点对癌症患者的中性粒细胞减少症进行监测。

Monitoring Neutropenia for Cancer Patients at the Point of Care.

作者信息

Inan Hakan, Kingsley James L, Ozen Mehmet O, Tekin Huseyin Cumhur, Hoerner Christian R, Imae Yoriko, Metzner Thomas J, Preiss Jordan S, Durmus Naside Gozde, Ozsoz Mehmet, Wakelee Heather, Fan Alice C, Tüzel Erkan, Demirci Utkan

机构信息

Demirci Bio-Acoustic-MEMS in Medicine (BAMM) Laboratory, Stanford University School of Medicine.

Department of Physics, Worcester Polytechnic Institute, 100 Institute Road, Worcester, MA 01609-2280, USA.

出版信息

Small Methods. 2017 Sep 11;1(9). doi: 10.1002/smtd.201700193. Epub 2017 Aug 9.

Abstract

Neutrophils have a critical role in regulating the immune system. The immune system is compromised during chemotherapy, increasing infection risks and imposing a need for regular monitoring of neutrophil counts. Although commercial hematology analyzers are currently used in clinical practice for neutrophil counts, they are only available in clinics and hospitals, use large blood volumes, and are not available at the point of care (POC). Additionally, phlebotomy and blood processing require trained personnel, where patients are often admitted to hospitals when the infections are at late stage due to lack of frequent monitoring. Here, a reliable method is presented that selectively captures and quantifies white blood cells (WBCs) and neutrophils from a finger prick volume of whole blood by integrating microfluidics with high-resolution imaging algorithms. The platform is compact, portable, and easy to use. It captures and quantifies WBCs and neutrophils with high efficiency (>95%) and specificity (>95%) with an overall 4.2% bias compared to standard testing. The results from a small cohort of patients ( = 11 healthy, = 5 lung and kidney cancer) present a unique disposable cell counter, demonstrating the ability of this tool to monitor neutrophil and WBC counts within clinical or in resource-constrained environments.

摘要

中性粒细胞在调节免疫系统中起着关键作用。化疗期间免疫系统会受到损害,增加感染风险,并需要定期监测中性粒细胞计数。虽然目前临床实践中使用商业血液分析仪进行中性粒细胞计数,但它们仅在诊所和医院可用,需要大量血液,且无法在护理点(POC)使用。此外,静脉穿刺和血液处理需要经过培训的人员,由于缺乏频繁监测,患者在感染晚期往往才被送往医院。在此,提出了一种可靠的方法,通过将微流体技术与高分辨率成像算法相结合,从手指针刺采集的全血样本中选择性地捕获和定量白细胞(WBC)和中性粒细胞。该平台紧凑、便携且易于使用。它能高效(>95%)且特异(>95%)地捕获和定量白细胞和中性粒细胞,与标准检测相比总体偏差为4.2%。一小群患者(11名健康人、5名肺癌和肾癌患者)的结果展示了一种独特的一次性细胞计数器,证明了该工具在临床或资源有限环境中监测中性粒细胞和白细胞计数的能力。

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