自动图像分析系统与快速流式细胞术在白细胞减少性疾病诊治中的价值

doi:10.3969/j.issn.1673-8640.2020.04.015

摘要/Abstract

摘要：

目的探讨自动图像分析系统与快速流式细胞术在白细胞减少性疾病诊治中的价值。方法分别采用自动图像分析系统、快速流式细胞术和显微镜镜检法对白细胞计数为（0.5~2.0）×10⁹/L的181例患者进行白细胞分类计数。以显微镜镜检法为参考方法,比较上述方法白细胞分类计数的时间、精密度以及原始细胞检测相关性、敏感性与特异性。结果显微镜镜检法、快速流式细胞术、自动图像分析系统预分类和自动图像分析系统预分类+人工审核白细胞分类计数中位时间分别为864 s、277 s、190 s、364 s;快速流式细胞术中性粒细胞、淋巴细胞、单核细胞和原始细胞分类计数结果的离散度优于其他3种方法。快速流式细胞术、自动图像分析系统预分类、自动图像分析系统预分类+人工审核检测原始细胞的敏感性和特异性分别为94.90%和98.80%、54.08%和74.69%、79.59%和100.00%,与显微镜镜检法的r值分别为0.937、0.507、0.990。结论自动图像分析系统+人工审核与快速流式细胞术可快速、准确地检测出低值白细胞样本中的原始细胞,对患者疾病的诊断、治疗及预后判断具有重要价值。

关键词: 白细胞减少, 自动图像分析系统, 快速流式细胞术

Abstract:

Objective To evaluate the roles of automated image analysis system and CytoDiff flow cytometry for the diagnosis and treatment of leucopenia. Methodse A total of 181 patients with white blood cell count（0.5-2.0）×10⁹/L were enrolled and determined for differentiation and count by automated image analysis system and CytoDiff flow cytometry. Time,precision,correlation of blasts,sensitivity and specificity were compared with microscopy（standard method）. Results The median times were 864,277,190 and 364 s by microscopy,CytoDiff flow cytometry,DM96 preclassification and DM96 reclassification,respectively. The variation of CytoDiff flow cytometry for neutrophils,lymphocytes,monocytes and blasts was better than those of the other 3 methods. The correlation coefficients（r） between CytoDiff flow cytometry,DM96 preclassification,DM96 reclassification and microscopy were 0.937,0.507 and 0.990,respectively. The sensitivity and specificity of CytoDiff flow cytometry were 94.90% and 98.80%,respectively. The sensitivities of DM96 preclassification and DM96 reclassification were 54.08% and 79.59%,and the specificities were 74.69% and 100.00%,respectively. Conclusions DM96 reclassification and CytoDiff flow cytometry can detect blasts in leucopenia samples with high efficiency and accuracy and meet the demand of clinic for the curative effect monitoring and prognostic analysis.

Key words: Leucopenia, Automated image analysis system, CytoDiff flow cytometry

中图分类号:

R446.1

郭平, 陈骊婷, 廖兵, 王剑飚. 自动图像分析系统与快速流式细胞术在白细胞减少性疾病诊治中的价值[J]. 检验医学, 2020, 35(4): 349-353.

GUO Ping, CHEN Liting, LIAO Bing, WANG Jianbiao. Roles of automated image analysis system and CytoDiff flow cytometry for the diagnosis and treatment of leucopenia[J]. Laboratory Medicine, 2020, 35(4): 349-353.

图/表 6

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方法	中位耗时	最小耗时	最大耗时
显微镜镜检法	864	831	936
快速流式细胞术	277^*	244	302
自动图像分析系统预分类	190^*#	183	230
自动图像分析系统预分类 +人工审核	364^*#△	335	371

方法	中位耗时	最小耗时	最大耗时
显微镜镜检法	864	831	936
快速流式细胞术	277^*	244	302
自动图像分析系统预分类	190^*#	183	230
自动图像分析系统预分类 +人工审核	364^*#△	335	371

方法	中性粒细胞	淋巴细胞	单核细胞	原始细胞
显微镜镜检法	47.00±3.27	26.00±3.46	10.00±2.66	13.00±2.07
快速流式细胞术	43.00±1.13	28.00±0.49	12.00±0.47	13.00±0.50
自动图像分析系统预分类	38.00±1.33	43.00±0.63	4.00±1.17	6.00±0.98
自动图像分析系统预分类+人工审核	42.00±1.47	30.00±3.14	6.00±1.17	16.00±1.33

方法	中性粒细胞	淋巴细胞	单核细胞	原始细胞
显微镜镜检法	47.00±3.27	26.00±3.46	10.00±2.66	13.00±2.07
快速流式细胞术	43.00±1.13	28.00±0.49	12.00±0.47	13.00±0.50
自动图像分析系统预分类	38.00±1.33	43.00±0.63	4.00±1.17	6.00±0.98
自动图像分析系统预分类+人工审核	42.00±1.47	30.00±3.14	6.00±1.17	16.00±1.33

显微镜镜检法	例数	快速流式细胞术		自动图像分析系统预分类		自动图像分析系统预分类+ 人工审核
显微镜镜检法	例数	阳性	阴性	阳性	阴性	阳性	阴性
+	98	93	5	53	45	78	20
-	83	1	82	21	62	0	83
合计	181	94	87	74	107	78	103