Egger Margot, Fang I-Fei, Quehenberger Franz, Robier Christoph
Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz and Ordensklinikum Linz, Linz, Austria.
Medical Faculty, Johannes Kepler University Linz, Linz, Austria.
Clin Chem Lab Med. 2025 Mar 17;63(7):1427-1431. doi: 10.1515/cclm-2025-0115. Print 2025 Jun 26.
In patients with chronic lymphocytic leukemia (CLL), the white progenitor cell (WPC) channel of the Sysmex XN hematology analyzers typically shows a varying proportion of cells in the upper left field of the scattergram, resembling the shape of shark fins. The underlying mechanism causing this phenomenon has not been elucidated so far. In this study we evaluated biological and/or genetic features of CLL cells as a potential background of the "shark fins".
Automated blood counts and WPC scattergrams of 95 CLL patients were analyzed. The scattergrams were examined for the presence, count and percentage of cells in the "shark fins" using a flow cytometry software. Potential influencing factors on the occurrence of the "shark fin" cells were statistically tested by Spearman correlation.
The lymphocyte count was identified as a highly statistically significant predictor of "shark fins" (p<0.0001). Absence of del(17p) (p=0.02), unmutated TP53 (p=0.01), mutated IGHV (p=0.03) and the percentage of smudge cells in peripheral blood smears (p=0.04) showed a statistically significant positive influence on the percentage of cells in the "shark fins" after adjustment for the lymphocyte count. No significant effect was observed for age, sex, del(13q), del(11q), trisomy 12 and treatment.
We identified the lymphocyte count, the absence of TP53 mutations and del(17p), a mutated IGHV and the proportion of smudge cells as significant influences on the appearance of "shark fin" cells. Our findings indicate an impact of biological and genetic properties of the leukemic cells on the formation of "shark fins".
在慢性淋巴细胞白血病（CLL）患者中，Sysmex XN血液分析仪的白细胞祖细胞（WPC）通道在散点图的左上方区域通常显示不同比例的细胞，类似鱼鳍的形状。迄今为止，导致这种现象的潜在机制尚未阐明。在本研究中，我们评估了CLL细胞的生物学和/或遗传学特征，作为“鱼鳍”现象的潜在背景。
分析了95例CLL患者的自动血细胞计数和WPC散点图。使用流式细胞术软件检查散点图中“鱼鳍”内细胞的存在情况、计数和百分比。通过Spearman相关性对“鱼鳍”细胞出现的潜在影响因素进行统计学检验。
淋巴细胞计数被确定为“鱼鳍”现象具有高度统计学意义的预测指标（p<0.0001）。在调整淋巴细胞计数后缺失del(17p)（p=0.02）、未突变的TP53（p=0.01）、突变的IGHV（p=0.03）以及外周血涂片上涂抹细胞的百分比（p=0.04）对“鱼鳍”内细胞的百分比显示出统计学上显著的正影响。未观察到年龄、性别、del(13q)、del(11q)、三体12和治疗有显著影响。
我们确定淋巴细胞计数、TP53突变和del(17p)的缺失、IGHV突变以及涂抹细胞的比例对“鱼鳍”细胞的出现有显著影响。我们的研究结果表明白血病细胞的生物学和遗传学特性对“鱼鳍”的形成有影响。
