Department of Clinical Laboratory, Juntendo University Hospital, Tokyo, Japan.
Department of Next Generation Hematology Laboratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Int J Lab Hematol. 2023 Aug;45(4):460-468. doi: 10.1111/ijlh.14058. Epub 2023 Mar 12.
This study evaluated the feasibility of the Sysmex XN-3000 automated hematology analyzer for the assessment of total nucleated cells (TNC) and bone marrow (BM) cell density in routine bone marrow aspiration (BMA) samples.
A total of 54 BMA samples from 39 hematological patients were evaluated. The number of megakaryocytes was calculated by a specific gating algorithm using the body fluid mode of the WBC differential (WDF) channel. Lipid contents were calculated through a newly developed algorithm utilizing the WDF channel. The ratio of lipid particles over TNCs by the WNR channel was compared with the BM cellularity assessed by the BM biopsy. The myeloid/erythroid (M/E) ratio was calculated by measuring the number of myeloid cells in the WDF channel and the number of nucleated red blood cells (NRBCs) in the WNR channel.
XN-3000 counts and microscopic results showed a linear correlation in TNC (R = .98, p < .001), megakaryocytes (R = .59, p = .002), NRBC (R = .84, p < .001), and M/E ratio (R = .59, p < .001). There were significant differences in the lipid/TNC ratios of hypercellular, normocellular, and hypocellular BMs measured by XN-3000 (p < .001). Receiver-operating characteristic analysis detected cut-off values of the lipid/TNC ratio of >0.4054 for hypoplasia and <0.157 for hyperplasia. The sensitivity and specificity for hypoplasia were 100% and 88%, and for hyperplasia were 89% and 86%, respectively.
XN-3000 provides a quantitative assessment of BM cellularity, supporting the qualitative assessment by myelogram and BM biopsy.
本研究评估了 Sysmex XN-3000 全自动血液分析仪在常规骨髓抽吸 (BMA) 样本中评估总核细胞 (TNC) 和骨髓 (BM) 细胞密度的可行性。
共评估了 39 例血液病患者的 54 例 BMA 样本。使用白细胞(WBC)差异(WDF)通道的体液模式，通过特定的门控算法计算巨核细胞数。通过利用 WDF 通道开发的新算法计算脂质含量。WNR 通道的脂质颗粒与 BM 活检评估的 BM 细胞密度的比值与 BM 细胞密度进行比较。通过测量 WDF 通道中的髓细胞数和 WNR 通道中的有核红细胞 (NRBC) 数来计算骨髓细胞与红细胞的比值 (M/E)。
XN-3000 计数与显微镜结果显示 TNC（R = .98，p < .001）、巨核细胞（R = .59，p = .002）、NRBC（R = .84，p < .001）和 M/E 比值（R = .59，p < .001）具有线性相关性。XN-3000 测量的高细胞、正常细胞和低细胞 BM 的脂质/TNC 比值有显著差异（p < .001）。受试者工作特征分析检测到脂质/TNC 比值>0.4054 为发育不良的截断值，<0.157 为增生的截断值。发育不良的灵敏度和特异性分别为 100%和 88%，增生的灵敏度和特异性分别为 89%和 86%。
XN-3000 提供了 BM 细胞密度的定量评估，支持骨髓涂片和 BM 活检的定性评估。
