Hübl W, Andert S, Thum G, Ortner S, Bayer P M
Central Laboratory, Wilhelminenspital, Vienna, Austria.
Am J Clin Pathol. 1997 Feb;107(2):187-96. doi: 10.1093/ajcp/107.2.187.
Fc gamma RIII (CD16) expression of neutrophil granulocytes was measured in 156 patients by means of fluorescence-labeled antibodies with a flow cytometer. Results were compared with (1) 400-cell manual differential count; (2) left shift flagging on hematology analyzers; (3) absolute neutrophil count; and (4) acute-phase protein levels. Asynchrony was noted between neutrophil CD16 expression and microscopically defined neutrophil stage, particularly in heavily left-shifted samples, which made it impossible to reliably enumerate immature neutrophils on the basis of CD16 expression. According to receiver operating characteristics, the absolute count of CD16-negative neutrophils was highly discriminatory for detection of left shift, with an area under the curve (AUC) of 0.842 +/- 0.03 (SE) and maximum efficiency of 81% +/- 3%, but absolute neutrophil count was not significantly inferior (0.821 +/- 0.03 and 76% +/- 3%). STKS and SE9000 flagging demonstrated efficiency of 76% +/- 3% and 81% +/- 3%, respectively. For detection of acute-phase response, absolute neutrophil count (AUC, 0.836 +/- 0.04; maximum efficiency, 80% +/- 4%) outperformed both quantitative neutrophil CD16 expression (0.760 +/- 0.05; 75% +/- 4%) and absolute CD16-negative neutrophil count (0.757 +/- 0.05; 71% +/- 4%); absolute band count performed similarly (0.853 +/- 0.04; 79% +/- 4%) and showed high efficiency at high sensitivity and specificity. Efficiency of analyzer flagging for detection of acute-phase response was not superior to absolute neutrophil count (STKS, 77% +/- 4%; SE9000, 78% +/- 4%). In conclusion, the diagnostic value of measuring neutrophil CD16 expression was generally similar to that of less complicated analytes.
采用荧光标记抗体和流式细胞仪，对156例患者中性粒细胞的FcγRIII（CD16）表达进行了检测。将结果与以下各项进行比较：（1）400个细胞的手工分类计数；（2）血液分析仪上的核左移标记；（3）中性粒细胞绝对计数；以及（4）急性期蛋白水平。发现中性粒细胞CD16表达与显微镜下定义的中性粒细胞阶段之间存在不同步，特别是在核左移严重的样本中，这使得无法根据CD16表达可靠地计数未成熟中性粒细胞。根据受试者工作特征曲线，CD16阴性中性粒细胞的绝对计数对核左移检测具有高度鉴别性，曲线下面积（AUC）为0.842±0.03（标准误），最大效率为81%±3%，但中性粒细胞绝对计数并不明显逊色（0.821±0.03和76%±3%）。STKS和SE9000标记的效率分别为76%±3%和81%±3%。对于急性期反应的检测，中性粒细胞绝对计数（AUC，0.836±0.04；最大效率，80%±4%）优于中性粒细胞CD16定量表达（0.760±0.05；75%±4%）和CD16阴性中性粒细胞绝对计数（0.757±0.05；71%±4%）；杆状核细胞绝对计数表现相似（0.853±0.04；79%±4%），并在高灵敏度和特异性下显示出高效率。分析仪标记对急性期反应检测的效率并不优于中性粒细胞绝对计数（STKS，77%±4%；SE9000，78%±4%）。总之，测量中性粒细胞CD16表达的诊断价值通常与不太复杂的分析物相似。
