中性粒细胞散射数据驱动的急性白血病病例微观前标记

NEUTROPHIL SCATTERING DATA DRIVEN PRE-MICROSCOPIC FLAGGING OF ACUTE LEUKEMIC CASES.

作者信息

Zeeshan-Haider Rana, Urrechaga Eloisa, Uddin-Ujjan Ikram, Sultan-Shamsi Tahir

机构信息

National Institute of Blood Disease and Bone Marrow Transplantation, Karachi, Pakistan.

Hematology Laboratory, Hospital Galdakao-Usansolo, Galdakao, Spain.

出版信息

Rev Invest Clin. 2020;72(1):37-45. doi: 10.24875/RIC.19003194.

DOI:10.24875/RIC.19003194

PMID:32132736

Abstract

BACKGROUND

The hematology analyzer, Sysmex XN-1000, generates white blood cell count with varying scattering intensities during a complete blood count (CBC) analysis.

OBJECTIVES

The objectives of the study were to study the predictive role of median and coefficient of variation of neutrophil scattering items in blood samples for differentiation of leukemic subjects.

METHODS

We evaluated six neutrophil scattering parameters: neutrophil side scatter mean intensity, neutrophil side fluorescence light (SFL) mean intensity, neutrophil forward scatter mean intensity, neutrophil side scatter area distribution width (NE-WX), neutrophil SFL area distribution width (NE-WY), and neutrophil forward scatter area distribution width (NE-WZ), measured in white blood cell differential scattergram generated by the hematology analyzer (Sysmex XN-1000) at an academic medical center.

RESULTS

We collected 433 blood samples from acute myeloid leukemia (AML) and acute lymphoid leukemia (ALL) cases and normal controls. AML group showed highly significant differences in the mean values compared with the control group. Out of six neutrophil scattering items, NE-WX, NE-WY, and NE-WZ showed high efficiency, with area under the curve (AUC) values of 0.764, 0.748, and 0.757, respectively, to differentiate AML from ALL cases and control groups. When comparing combined acute leukemia cases (AML plus ALL) with the control group, NE-WX, NE-WY, and NE-WZ generated highly significant AUC values (0.840, 0.884, and 0.801, respectively).

CONCLUSION

The neutrophil scattering parameters generated during CBC analysis provide a new tool for the prediction of acute leukemia and its lineage.

摘要

背景

血液分析仪Sysmex XN - 1000在全血细胞计数（CBC）分析过程中会产生具有不同散射强度的白细胞计数。

目的

本研究的目的是探讨血液样本中中性粒细胞散射项目的中位数和变异系数在白血病患者鉴别诊断中的预测作用。

方法

我们评估了六个中性粒细胞散射参数：中性粒细胞侧向散射平均强度、中性粒细胞侧向荧光（SFL）平均强度、中性粒细胞前向散射平均强度、中性粒细胞侧向散射面积分布宽度（NE - WX）、中性粒细胞SFL面积分布宽度（NE - WY）和中性粒细胞前向散射面积分布宽度（NE - WZ），这些参数是在一家学术医疗中心使用血液分析仪（Sysmex XN - 1000）生成的白细胞微分散射图中测量得到的。

结果

我们收集了来自急性髓系白血病（AML）、急性淋巴细胞白血病（ALL）病例及正常对照的433份血液样本。AML组与对照组相比，平均值存在高度显著差异。在六个中性粒细胞散射项目中，NE - WX、NE - WY和NE - WZ显示出高效性，将AML与ALL病例及对照组区分开来的曲线下面积（AUC）值分别为0.764、0.748和0.757。当将合并的急性白血病病例（AML加ALL）与对照组进行比较时，NE - WX、NE - WY和NE - WZ产生了高度显著的AUC值（分别为0.840、0.884和0.801）。