Docemus Onlus "Theoretical and Practical Training School for Improving Specialty Medicine", Torrevecchia Teatina, Italy.
U.O. Patologia Clinica A.O.R.N. "G. Rummo", Benevento, Italy.
Int J Lab Hematol. 2021 Aug;43(4):581-587. doi: 10.1111/ijlh.13552. Epub 2021 Apr 23.
3D-DIFF scattergram of the Mindray BC-6800 haematological analyser shows morphological abnormalities and lymphocyte cluster splitting related to the presence of reactive lymphocytes. This study aims to assess whether these cytographic changes are useful in detecting both activated and apoptotic lymphocytes, leading to an improvement in the laboratory diagnostic process of infectious mononucleosis.
Two hundred three samples with modified shape and doubled lymphocyte cluster of DIFF scattergram (study group) were divided into two different subgroups: with and, respectively, without serological evidence of ongoing IM. Activated and apoptotic cells in peripheral blood were counted by light microscopy or gating in the instrumental dot plots. Values of apoptotic cells counted by microscopy were compared with those resulting from gating.
Samples with both shape change and doubled lymphocyte cluster had serological profiles according to the diagnosis of ongoing infectious mononucleosis. Blood smears review was positive for reactive lymphocytes in all 112 samples (100%). An underestimation of apoptotic cell count by light microscopy compared with the gating in the instrumental scatterplot was also observed (96 out of 112, 85.7%).
The additional lymphocyte cluster was significantly associated with activated and apoptotic lymphocytes in samples with serology suggesting ongoing infectious mononucleosis. Considering the significance of clue for infectious mononucleosis assigned to the apoptotic lymphocytes, a specific flag such as "apoptotic cells?" could be associate with the related cluster. Such a flag could be used for dedicated rules for smears review, thus increasing infectious mononucleosis detection in laboratories that do not usually practise instrumental cytograms observation.
迈瑞 BC-6800 血液分析仪的 3D-DIFF 散点图显示形态异常和与反应性淋巴细胞存在相关的淋巴细胞簇分裂。本研究旨在评估这些细胞图像变化是否有助于检测活化和凋亡淋巴细胞，从而改善传染性单核细胞增多症的实验室诊断过程。
203 例 DIFF 散点图形状改变和淋巴细胞簇加倍的样本（研究组）分为两组：分别具有和不具有正在进行的 IM 的血清学证据。通过光镜或仪器点图中的门控计数外周血中的活化和凋亡细胞。通过显微镜计数的凋亡细胞值与门控结果进行比较。
具有形状改变和双倍淋巴细胞簇的样本具有根据正在进行的传染性单核细胞增多症诊断的血清学特征。所有 112 例样本（100%）的血涂片检查均为反应性淋巴细胞阳性。与仪器散射图中的门控相比，光镜计数的凋亡细胞也存在低估（112 例中有 96 例，85.7%）。
在提示正在进行的传染性单核细胞增多症的具有血清学的样本中，额外的淋巴细胞簇与活化和凋亡淋巴细胞显著相关。考虑到赋予凋亡淋巴细胞的传染性单核细胞增多症的线索的重要性，可以将一个特定的标志（如“凋亡细胞？”）与相关簇相关联。这样的标志可用于专门针对涂片检查的规则，从而增加不常进行仪器细胞图像观察的实验室中传染性单核细胞增多症的检测。
