Department of Radiotherapy-Radiooncology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building A1, 48149 Muenster, Germany.
Department of Anesthesiology and Intensive Care and Pain Medicine, University Hospital of Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
Cells. 2022 Feb 21;11(4):755. doi: 10.3390/cells11040755.
In a prospective observational pilot study on patients undergoing elective cardiac surgery with cardiopulmonary bypass, we evaluated label-free quantitative phase imaging (QPI) with digital holographic microscopy (DHM) to describe perioperative inflammation by changes in biophysical cell properties of lymphocytes and monocytes. Blood samples from 25 patients were investigated prior to cardiac surgery and postoperatively at day 1, 3 and 6. Biophysical and morphological cell parameters accessible with DHM, such as cell volume, refractive index, dry mass, and cell shape related form factor, were acquired and compared to common flow cytometric blood cell markers of inflammation and selected routine laboratory parameters. In all examined patients, cardiac surgery induced an acute inflammatory response as indicated by changes in routine laboratory parameters and flow cytometric cell markers. DHM results were associated with routine laboratory and flow cytometric data and correlated with complications in the postoperative course. In a subgroup analysis, patients were classified according to the inflammation related C-reactive protein (CRP) level, treatment with epinephrine and the occurrence of postoperative complications. Patients with regular courses, without epinephrine treatment and with low CRP values showed a postoperative lymphocyte volume increase. In contrast, the group of patients with increased CRP levels indicated an even further enlarged lymphocyte volume, while for the groups of epinephrine treated patients and patients with complicative courses, no postoperative lymphocyte volume changes were detected. In summary, the study demonstrates the capability of DHM to describe biophysical cell parameters of perioperative lymphocytes and monocytes changes in cardiac surgery patients. The pattern of correlations between biophysical DHM data and laboratory parameters, flow cytometric cell markers, and the postoperative course exemplify DHM as a promising diagnostic tool for a characterization of inflammatory processes and course of disease.
在一项针对接受体外循环心脏手术的择期心脏手术患者的前瞻性观察性初步研究中，我们评估了无标记定量相位成像（QPI）与数字全息显微镜（DHM），通过淋巴细胞和单核细胞的生物物理细胞特性变化来描述围手术期炎症。在心脏手术前和手术后第 1、3 和 6 天，对 25 例患者的血液样本进行了研究。使用 DHM 可获得生物物理和形态学细胞参数，例如细胞体积、折射率、干质量和与细胞形状相关的形状因子，并将其与炎症的常见流式细胞术血细胞标志物和选定的常规实验室参数进行比较。在所有检查的患者中，心脏手术引起了急性炎症反应，这表明常规实验室参数和流式细胞术细胞标志物发生了变化。DHM 结果与常规实验室和流式细胞术数据相关，并与术后过程中的并发症相关。在亚组分析中，根据与炎症相关的 C 反应蛋白（CRP）水平、肾上腺素治疗和术后并发症的发生情况对患者进行分类。具有正常病程、无肾上腺素治疗和 CRP 值较低的患者术后淋巴细胞体积增加。相比之下，CRP 值升高的患者组的淋巴细胞体积甚至进一步增大，而肾上腺素治疗患者组和并发患者组则未检测到术后淋巴细胞体积变化。总之，该研究表明 DHM 具有描述心脏手术患者围手术期淋巴细胞和单核细胞生物物理细胞参数变化的能力。DHM 数据与实验室参数、流式细胞术细胞标志物和术后病程之间的相关性模式表明，DHM 是一种有前途的诊断工具，可用于描述炎症过程和疾病进程。
