Ningombam Aparna, Sarkar Abhirup, Acharya Shreyam, Chopra Anita, Kumar Kundan, Subramanian Arulselvi
Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India.
Department of Laboratory Oncology, All India Institute of Medical Sciences, New Delhi, 110029 India.
Indian J Hematol Blood Transfus. 2020 Jul;36(3):512-518. doi: 10.1007/s12288-020-01276-x. Epub 2020 Apr 3.
Malaria, an important parasitic disease worldwide, still has diagnostic challenges in the laboratory. Many studies have been conducted on the detection ability of haematology analysers for malaria. We evaluated the Sysmex XN-series analyser as a tool for detection of malaria by analysing the leukocyte cell population data (LCPD), scattergrams and associated Flow Cytometry Standard (FCS) data from both the WNR (white cell nucleated) and WDF (white cell differential) channels. 1281 clinically suspected cases of malaria were screened for malaria by peripheral blood smear examination and were run in the Sysmex XN-1000 for analysis of haematological parameter data, LCPD, all the scattergrams and FCS data. 1281 clinically suspected cases of malaria were screened for malaria by peripheral blood smear examination and were run in the Sysmex XN-1000 for analysis of haematological parameter data, LCPD, all the scattergrams and FCS data. 48 cases had malarial parasite on microscopy; of which, 41 cases were of , 6 cases of and 1 case of mixed infection. 46 malaria-positive samples showed certain patterns of clusters in the scattergrams of both WDF and WNR channels. A case with only a few ring forms of and another with very low parasite load having only gametocyte of didn't show the distinctive cluster. The most distinctive clusters for all other cases were seen in WNR (SFL-SSC) and WNR (SSC-FSC) scattergrams. FCS data for the same were analysed to gate for those events. The gated events correlated (Spearman ρ = 0.77, < 0.01) with the parasite load of the patients. By observing the scattergrams and different parameters in the Sysmex XN-series analyser, malaria can be detected from the analyser itself.
疟疾是一种在全球范围内重要的寄生虫病，在实验室诊断方面仍面临挑战。针对血液分析仪检测疟疾的能力，已经开展了许多研究。我们通过分析来自WNR（有核白细胞）和WDF（白细胞分类）通道的白细胞群体数据（LCPD）、散点图及相关的流式细胞术标准（FCS）数据，评估了Sysmex XN系列分析仪作为疟疾检测工具的性能。对1281例临床疑似疟疾病例进行外周血涂片检查以筛查疟疾，并在Sysmex XN - 1000上进行检测，以分析血液学参数数据、LCPD、所有散点图和FCS数据。对1281例临床疑似疟疾病例进行外周血涂片检查以筛查疟疾，并在Sysmex XN - 1000上进行检测，以分析血液学参数数据、LCPD、所有散点图和FCS数据。48例在显微镜检查下发现疟原虫；其中，41例为[具体疟原虫种类1]，6例为[具体疟原虫种类2]，1例为混合感染。46份疟疾阳性样本在WDF和WNR通道的散点图中显示出特定的聚类模式。仅有少量[具体疟原虫种类1]环状体的一例以及疟原虫载量极低且仅含[具体疟原虫种类2]配子体的另一例未显示出明显的聚类。所有其他病例最明显的聚类出现在WNR（SFL - SSC）和WNR（SSC - FSC）散点图中。对相同样本的FCS数据进行分析以确定这些事件的门控。门控事件与患者疟原虫载量相关（Spearman ρ = 0.77，P < 0.01）。通过观察Sysmex XN系列分析仪中的散点图和不同参数，可以从分析仪本身检测出疟疾。
